Registering regions of interest of a body part to a coordinate system

ABSTRACT

Described embodiments include a system, method, and computer program product. A described system includes a receiver circuit that receives at least two medical images that each includes a respective region of interest of a mammalian body part. The receiver circuit also receives at least two reference images that each includes a respective landmark subsurface feature of the mammalian body part. Each landmark subsurface feature has a respective spatial relationship to a respective region of interest. The system includes a coordinate analysis circuit configured to determine a common frame of reference at least partially based on a landmark subsurface feature included in a reference image. The system includes a registration circuit configured to register the respective regions of interest. The registration is based on the determined common frame of reference. The system includes a computer-readable media configured to maintain informational data corresponding to the respective registered regions of interest.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is related to and claims the benefit of theearliest available effective filing date(s) from the following listedapplication(s) (the “Related applications”) (e.g., claims earliestavailable priority dates for other than provisional patent applicationsor claims benefits under 35 USC §119(e) for provisional patentapplications, for any and all parent, grandparent, great-grandparent,etc. applications of the Related application(s)).

RELATED APPLICATIONS

For purposes of the USPTO extra-statutory requirements, the presentapplication constitutes a continuation-in-part of United States patentapplication No. To be assigned, entitled REGISTERING A REGION OFINTEREST OF A BODY PART TO A LANDMARK SUBSURFACE FEATURE OF THE BODYPART, naming Roderick A. Hyde, Jordin T. Kare, Eric C. Leuthardt, ErezLieberman, Dennis J. Rivet, Elizabeth A. Sweeney, Lowell L. Wood, Jr.,as inventors, filed Sep. 16, 2011, which is currently co-pending, or isan application of which a currently co-pending application is entitledto the benefit of the filing date.

For purposes of the USPTO extra-statutory requirements, the presentapplication constitutes a continuation-in-part of United States patentapplication No. To be assigned, entitled COREGISTERING IMAGES OF AREGION OF INTEREST DURING SEVERAL CONDITIONS USING A LANDMARK SUBSURFACEFEATURE, naming Roderick A. Hyde, Jordin T. Kare, Eric C. Leuthardt,Erez Lieberman, Dennis J. Rivet, Elizabeth A. Sweeney, Lowell L. Wood,Jr., as inventors, filed Sep. 16, 2011, which is currently co-pending,or is an application of which a currently co-pending application isentitled to the benefit of the filing date.

For purposes of the USPTO extra-statutory requirements, the presentapplication constitutes a continuation-in-part of United States patentapplication No. To be assigned, entitled CREATING A SUBSURFACE FEATUREATLAS OF AT LEAST TWO SUBSURFACE FEATURES, naming Roderick A. Hyde,Jordin T. Kare, Eric C. Leuthardt, Erez Lieberman, Dennis J. Rivet,Elizabeth A. Sweeney, Lowell L. Wood, Jr., as inventors, filed Sep. 16,2011, which is currently co-pending, or is an application of which acurrently co-pending application is entitled to the benefit of thefiling date.

For purposes of the USPTO extra-statutory requirements, the presentapplication constitutes a continuation-in-part of United States patentapplication No. To be assigned, entitled INDICATING PROXIMITY OF ABODY-INSERTABLE DEVICE TO A DESTINATION REGION OF INTEREST, namingRoderick A. Hyde, Jordin T. Kare, Eric C. Leuthardt, Erez Lieberman,Dennis J. Rivet, Elizabeth A. Sweeney, Lowell L. Wood, Jr., asinventors, filed Sep. 16, 2011, which is currently co-pending, or is anapplication of which a currently co-pending application is entitled tothe benefit of the filing date.

For purposes of the USPTO extra-statutory requirements, the presentapplication constitutes a continuation-in-part of United States patentapplication No. To be assigned, entitled GUIDANCE INFORMATION INDICATINGAN OPERATIONAL PROXIMITY OF A BODY-INSERTABLE DEVICE TO A REGION OFINTEREST, naming Roderick A. Hyde, Jordin T. Kare, Eric C. Leuthardt,Erez Lieberman, Dennis J. Rivet, Elizabeth A. Sweeney, Lowell L. Wood,Jr., as inventors, filed Sep. 16, 2011, which is currently co-pending,or is an application of which a currently co-pending application isentitled to the benefit of the filing date.

For purposes of the USPTO extra-statutory requirements, the presentapplication constitutes a continuation-in-part of United States patentapplication No. To be assigned, entitled CONFIRMING THAT AN IMAGEINCLUDES AT LEAST A PORTION OF A TARGET REGION OF INTEREST, namingRoderick A. Hyde, Jordin T. Kare, Eric C. Leuthardt, Erez Lieberman,Dennis J. Rivet, Elizabeth A. Sweeney, Lowell L. Wood, Jr., asinventors, filed Sep. 16, 2011, which is currently co-pending, or is anapplication of which a currently co-pending application is entitled tothe benefit of the filing date.

For purposes of the USPTO extra-statutory requirements, the presentapplication constitutes a continuation-in-part of United States patentapplication No. To be assigned, entitled LISTING INSTANCES OF ABODY-INSERTABLE DEVICE BEING PROXIMATE TO TARGET REGIONS OF INTEREST,naming Roderick A. Hyde, Jordin T. Kare, Eric C. Leuthardt, ErezLieberman, Dennis J. Rivet, Elizabeth A. Sweeney, Lowell L. Wood, Jr.,as inventors, filed Sep. 16, 2011, which is currently co-pending, or isan application of which a currently co-pending application is entitledto the benefit of the filing date.

For purposes of the USPTO extra-statutory requirements, the presentapplication constitutes a continuation-in-part of United States patentapplication No. To be assigned, entitled PATIENT VERIFICATION BASED ON ALANDMARK SUBSURFACE FEATURE OF THE PATIENT'S BODY PART, naming RoderickA. Hyde, Jordin T. Kare, Eric C. Leuthardt, Erez Lieberman, Dennis J.Rivet, Elizabeth A. Sweeney, Lowell L. Wood, Jr., as inventors, filedSep. 16, 2011, which is currently co-pending, or is an application ofwhich a currently co-pending application is entitled to the benefit ofthe filing date.

For purposes of the USPTO extra-statutory requirements, the presentapplication constitutes a continuation-in-part of United States patentapplication No. To be assigned, entitled REPORTING IMAGED PORTIONS OF APATIENT'S BODY PART, naming Roderick A. Hyde, Jordin T. Kare, Eric C.Leuthardt, Erez Lieberman, Dennis J. Rivet, Elizabeth A. Sweeney, LowellL. Wood, Jr., as inventors, filed Sep. 16, 2011, which is currentlyco-pending, or is an application of which a currently co-pendingapplication is entitled to the benefit of the filing date.

The United States Patent Office (USPTO) has published a notice to theeffect that the USPTO's computer programs require that patent applicantsreference both a serial number and indicate whether an application is acontinuation or continuation-in-part. Stephen G. Kunin, Benefit ofPrior-Filed application, USPTO Official Gazette Mar. 18, 2003. Thepresent Applicant Entity (hereinafter “Applicant”) has provided above aspecific reference to the application(s) from which priority is beingclaimed as recited by statute. Applicant understands that the statute isunambiguous in its specific reference language and does not requireeither a serial number or any characterization, such as “continuation”or “continuation-in-part,” for claiming priority to U.S. patentapplications. Notwithstanding the foregoing, Applicant understands thatthe USPTO's computer programs have certain data entry requirements, andhence Applicant is designating the present application as acontinuation-in-part of its parent applications as set forth above, butexpressly points out that such designations are not to be construed inany way as any type of commentary or admission as to whether or not thepresent application contains any new matter in addition to the matter ofits parent application(s).

All subject matter of the Related applications and of any and allparent, grandparent, great-grandparent, etc. applications of the Relatedapplications is incorporated herein by reference to the extent suchsubject matter is not inconsistent herewith.

SUMMARY

For example, and without limitation, an embodiment of the subject matterdescribed herein includes a system. In this example, the system includesa receiver circuit configured to receive at least two medical images.Each medical image of the at least two medical images includes arespective region of interest of a mammalian body part. A medical imagemay have been selected or captured by a health care provider during acolonoscopy, such as by the health care provider activating a selectoror a camera during the colonoscopy. For example, the camera may becarried on the distal end of an endoscope used for the colonoscopy. Theregion of interest may have been selected for any reason, including apossible disease state, or marking the region of interest for futurereturn, for example, to monitor progression of disease or a lackthereof. Alternatively, the region of interest may have been selected bya machine during a virtual colonoscopy, or in response to a virtualcolonoscopy. The receiver circuit is also configured to receive at leasttwo reference images. Each reference image of the at least two referenceimages includes a respective landmark subsurface feature of themammalian body part. Each landmark subsurface feature has a respectivespatial relationship to a respective region of interest included in amedical image of the at least two medical images. For example, a firstlandmark subsurface feature has a first spatial relationship to thefirst region of interest, which allows it to act as a monument or apointer to the first region of interest. For example, the landmarksubsurface feature may include a physical structure, nerve, void,border, component, tissue, structural feature, or density variation ofthe body part. For example, the physical structure may include a duct, abend or curve in a tubular structure, or an organ such as a colon. Forexample, a first reference image may be acquired by a fluoroscope usedduring a colonoscopy. For example, a reference image may have beenacquired at the same time as a medical image, and depict both the distalend of the endoscope and the landmark subsurface feature.

In this example, the system includes a coordinate analysis circuitconfigured to determine a common frame of reference that is at leastpartially based on a landmark subsurface feature included in a referenceimage of the at least two reference images. For example, a determinedcommon frame of reference may be a three-axis Cartesian coordinatesystem having its zero point at the first landmark subsurface feature.Continuing with this example, the system includes a registration circuitconfigured to register the respective regions of interest included inthe at least two medical images, the registration is at least partiallybased on the determined common frame of reference. For example, with thedetermined common frame of reference, and with information indicatingthe spatial relationship of a second landmark subsurface feature to afirst landmark subsurface feature, the first region of interest and thesecond region of interest may be registered. In this example, the systemincludes a computer-readable media configured to maintain informationaldata corresponding to the respective registered regions of interestincluded in the at least two medical images.

The foregoing summary is illustrative only and is not intended to be inany way limiting. In addition to the illustrative aspects, embodiments,and features described above, further aspects, embodiments, and featureswill become apparent by reference to the drawings and the followingdetailed description.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates an example embodiment of a thin computing device inwhich embodiments may be implemented;

FIG. 2 illustrates an example embodiment of a general-purpose computingsystem in which embodiments may be implemented;

FIG. 3 illustrates an example environment in which embodiments may beimplemented;

FIG. 4 illustrates additional details of the mammalian body part of FIG.3;

FIG. 5 illustrates an example operational flow 300;

FIG. 6 illustrates alternative embodiments of the medical imagereceiving operation of FIG. 5;

FIG. 7 illustrates alternative embodiments of the medical imagereceiving operation of FIG. 5;

FIG. 8 illustrates alternative embodiments of the reference imagereceiving operation 350 of FIG. 5;

FIG. 9 illustrates alternative embodiments of the reference imagereceiving operation 350 of FIG. 5;

FIG. 10 illustrates alternative embodiments of the reference imagereceiving operation 350 of FIG. 5;

FIG. 11 illustrates alternative embodiments of the registrationoperation 410 of FIG. 5;

FIG. 12 illustrates alternative embodiments of the registrationoperation 410 of FIG. 5;

FIG. 13 illustrates alternative embodiments of the operational flow 300of FIG. 5;

FIG. 14 illustrates alternative embodiments of the operational flow 300of FIG. 5;

FIG. 15 illustrates a computer program product;

FIG. 16 illustrates an example system;

FIG. 17 illustrates an example operational flow;

FIG. 18 illustrates an example environment;

FIG. 19 illustrates an example operational flow;

FIG. 20 illustrates an alternative embodiment of the operational flow ofFIG. 19;

FIG. 21 illustrates an alternative embodiment of the first receptionoperation 1010 of FIG. 19;

FIG. 22 illustrates an alternative embodiment of the third receptionoperation 1030 of FIG. 19;

FIG. 23 illustrates an alternative embodiment of the operational flow1000 of FIG. 19;

FIG. 24 illustrates an alternative embodiment of the reference operation1050 of FIG. 19;

FIG. 25 illustrates an alternative embodiment of the registrationoperation 1060 of FIG. 19;

FIG. 26 illustrates an alternative embodiment of the storage operation1070 of FIG. 19;

FIG. 27 illustrates an alternative embodiment of the operational flow1000 of FIG. 19;

FIG. 28 illustrates an example computer program product;

FIG. 29 illustrates an example system;

FIG. 30 illustrates an example operational flow 1200;

FIG. 31 illustrates an alternative embodiment of the reference operation1210 described in conjunction with FIG. 30;

FIG. 32 illustrates an alternative embodiment of the operational flow1200 described in conjunction with FIG. 30;

FIG. 33 illustrates an example computer program product;

FIG. 34 illustrates an example system;

FIG. 35 illustrates an example environment;

FIG. 36 illustrates an example operational flow;

FIG. 37 illustrates an alternative embodiment of the operational flow1600 of FIG. 36;

FIG. 38 illustrates an alternative embodiment of the operational flow1600 of FIG. 36;

FIG. 39 illustrates an example computer program product;

FIG. 40 illustrates an example system;

FIG. 41 illustrates an example environment;

FIG. 42 illustrates three example reference images having respectivefields of view that respectively include landmark subsurface features;

FIG. 43 illustrates an example operational flow;

FIG. 44 illustrates an alternative embodiment of the operational flow2000 described in FIG. 43;

FIG. 45 illustrates an alternative embodiment of the operational flow2000;

FIG. 46 illustrates a computer program product;

FIG. 47 illustrates an alternative embodiment of the computer programproduct 2100 of FIG. 46;

FIG. 48 illustrates an example system;

FIG. 49 illustrates an example environment;

FIG. 50 illustrates an embodiment with a reference image having a fieldof view of the lumen or cavity of the mammalian body part;

FIG. 51 illustrates an example operational flow;

FIG. 52 illustrates an alternative embodiment of the operational flow2400 of FIG. 51;

FIG. 53 illustrates an alternative embodiment of the operational flow2400 of FIG. 51;

FIG. 54 illustrates a computer program product;

FIG. 55 illustrates an alternative embodiment of the programinstructions of the computer program product of FIG. 54;

FIG. 56 illustrates an example system 2600;

FIG. 57 illustrates an example operational flow;

FIG. 58 illustrates an alternative embodiment of the operational flow2700 of FIG. 57;

FIG. 59 illustrates an alternative embodiment of the operational flow2700 of FIG. 57;

FIG. 60 illustrates an alternative embodiment of the operational flow2700 of FIG. 57;

FIG. 61 illustrates an alternative embodiment of the operational flow2700 of FIG. 57;

FIG. 62 illustrates an alternative embodiment of the operational flow2700 of FIG. 57;

FIG. 63 illustrates an alternative embodiment of the operational flow2700 of FIG. 57;

FIG. 64 illustrates an example computer program product;

FIG. 65 illustrates an alternative embodiment of computer programproduct of FIG. 64;

FIG. 66 illustrates an example system 2900;

FIG. 67 illustrates an example environment 3000;

FIG. 68 illustrates an example operational flow;

FIG. 69 illustrates an alternative embodiment of the operational flow ofFIG. 68;

FIG. 70 illustrates an alternative embodiment of the operational flow ofFIG. 68;

FIG. 71 illustrates an alternative embodiment of the operational flow3100 of FIG. 68;

FIG. 72 illustrates an alternative embodiment of the operational flow3100 of FIG. 68;

FIG. 73 illustrates an example computer program product;

FIG. 74 illustrates an alternative embodiment of the computer programproduct of FIG. 73;

FIG. 75 illustrates an example system;

FIG. 76 illustrates an example operational flow;

FIG. 77 illustrates an alternative embodiment of the example operationalflow 3400 of FIG. 76;

FIG. 78 illustrates an example computer program product;

FIG. 79 illustrates an example system;

FIG. 80 illustrates an example environment;

FIG. 81 illustrates an example operational flow;

FIG. 82 illustrates an alternative embodiment of the operational flow3900 of FIG. 81;

FIG. 83 illustrates an alternative embodiment of the operational flow;

FIG. 84 illustrates an example computer program product;

FIG. 85 illustrates an alternative embodiment of the computer programproduct 4000 of FIG. 84;

FIG. 86 illustrates an example system 4100;

FIG. 87 illustrates an example operational flow;

FIG. 88 illustrates an alternative embodiment of the operational flow;

FIG. 89 illustrates a computer program product;

FIG. 90 illustrates an example system;

FIG. 91 illustrates an example environment;

FIG. 92 illustrates an alternative embodiment of the environment 4400 ofFIG. 91;

FIG. 93 illustrates an example operational flow;

FIG. 94 illustrates an alternative embodiment of the operational flow4500 of FIG. 93;

FIG. 95 illustrates an alternative embodiment of the operational flow4500 of FIG. 93;

FIG. 96 illustrates an alternative embodiment of the operational flow4500 of FIG. 93;

FIG. 97 illustrates a computer program product;

FIG. 98 illustrates an alternative embodiment of the computer programproduct 4600 of FIG. 97;

FIG. 99 illustrates an example system;

FIG. 100 illustrates an example operational flow;

FIG. 101 illustrates an alternative embodiment of the operational flow5000 of FIG. 100;

FIG. 102 illustrates an example environment;

FIG. 103 illustrates an environment in which the system of FIG. 102 maybe used to guide the body-insertable device into an operationalproximity to a region of interest;

FIG. 104 illustrates an example operational flow;

FIG. 105 illustrates an alternative embodiment of the first receptionoperation 5310 of FIG. 104;

FIG. 106 illustrates an alternative embodiment of the operational flowof FIG. 104;

FIG. 107 illustrates an alternative embodiment of the operational flow5300 of FIG. 104;

FIG. 108 illustrates an alternative embodiment of the operational flow5300 of FIG. 104;

FIG. 109 illustrates an alternative embodiment of the operational flow5300 of FIG. 104;

FIG. 110 illustrates an alternative embodiment of the operational flow5300 of FIG. 104;

FIG. 111 illustrates an example computer program product;

FIG. 112 illustrates an alternative embodiment of the computer programproduct of FIG. 111;

FIG. 113 illustrates an example system;

FIG. 114 illustrates an example operational flow;

FIG. 115 illustrates an example environment;

FIG. 116 illustrates an example operational flow;

FIG. 117 illustrates an alternative embodiment of the operational flowof FIG. 116;

FIG. 118 illustrates an alternative embodiment of the operational flowof FIG. 116;

FIG. 119 illustrates an alternative embodiment of the operational flowof FIG. 116;

FIG. 120 illustrates a computer program product;

FIG. 121 illustrates an example system;

FIG. 122 illustrates an example environment;

FIG. 123 illustrates an example operational flow;

FIG. 124 illustrates an alternative embodiment of the operational flow6200 of FIG. 123;

FIG. 125 illustrates an alternative embodiment of the operational flowof FIG. 123;

FIG. 126 illustrates an alternative embodiment of the operational flowof FIG. 123;

FIG. 127 illustrates an alternative embodiment of the operational flowof FIG. 123;

FIG. 128 illustrates an example computer program product;

FIG. 129 illustrates an alternative embodiment of the programinstructions;

FIG. 130 illustrates an example system;

FIG. 131 illustrates an example operational flow;

FIG. 132 illustrates an alternative embodiment of the operational flowof FIG. 131;

FIG. 133 illustrates an example computer program product;

FIG. 134 illustrates an example environment;

FIG. 135 illustrates an example operational flow;

FIG. 136 illustrates an alternative embodiment of the operational flow6700 of FIG. 134;

FIG. 137 illustrates an alternative embodiment of the operational flow6600 of FIG. 133;

FIG. 138 illustrates an alternative embodiment of the operational flow6600 of FIG. 133;

FIG. 139 illustrates a computer program product;

FIG. 140 illustrates an example system;

FIG. 141 illustrates an example environment;

FIG. 142 illustrates an example environment;

FIG. 143 illustrates an operational flow;

FIG. 144 illustrates an alternative embodiment of the operational flow7200 of FIG. 142;

FIG. 145 illustrates an alternative embodiment of the operational flow7200 of FIG. 142;

FIG. 146 illustrates an alternative embodiment of the operational flow7200 of FIG. 142;

FIG. 147 illustrates an alternative embodiment of the operational flow7200 of FIG. 142;

FIG. 148 illustrates an alternative embodiment of the operational flow7200 of FIG. 142;

FIG. 149 illustrates an example computer program product; and

FIG. 150 illustrates an example system.

DETAILED DESCRIPTION

In the following detailed description, reference is made to theaccompanying drawings, which form a part hereof. In the drawings,similar symbols typically identify similar components, unless contextdictates otherwise. The illustrated embodiments described in thedetailed description, drawings, and claims are not meant to be limiting.Other embodiments may be utilized, and other changes may be made,without departing from the spirit or scope of the subject matterpresented here.

FIG. 1 and the following discussion are intended to provide a brief,general description of an environment in which embodiments may beimplemented. FIG. 1 illustrates an example system that includes a thincomputing device 20, which may be included in an electronic device thatalso includes a device functional element 50. For example, a thincomputing device may include a computing device having limited resourcesor limited processing capability. In an embodiment, the electronicdevice may include any item having electrical or electronic componentsplaying a role in a functionality of the item, such as, for example, alimited resource computing device, a wireless communication device, amobile wireless communication device, a smart phone, an electronic pen,a handheld electronic writing device, a digital camera, a scanner, anultrasound device, an x-ray machine, a non-invasive imaging device, acell phone, a PDA, a Blackberry® device, or a printer. For example, athin computing device may be included in a refrigerator, a car, or anairplane, and may interface with or control a functional element of therefrigerator, car, or airplane. In another example, the thin computingdevice may be included in an implantable medical apparatus or device. Ina further example, the thin computing device may be operable tocommunicate with an implantable or implanted medical apparatus.

The thin computing device 20 includes a processing unit 21, a systemmemory 22, and a system bus 23 that couples various system componentsincluding the system memory 22 to the processing unit 21. The system bus23 may be any of several types of bus structures including a memory busor memory controller, a peripheral bus, and a local bus using any of avariety of bus architectures. The system memory includes read-onlymemory (ROM) 24 and random access memory (RAM) 25. A basic input/outputsystem (BIOS) 26, containing the basic routines that help to transferinformation between sub-components within the thin computing device 20,such as during start-up, is stored in the ROM 24. A number of programmodules may be stored in the ROM 24 or RAM 25, including an operatingsystem 28, one or more application programs 29, other program modules 30and program data 31.

A user may enter commands and information into the computing device 20through one of more input interfaces. An input interface may include atouch-sensitive display, or one or more switches or buttons withsuitable input detection circuitry. A touch-sensitive display isillustrated as a display 32 and screen input detector 33. One or moreswitches or buttons are illustrated as hardware buttons 44 connected tothe system via a hardware button interface 45. The output circuitry ofthe touch-sensitive display 32 is connected to the system bus 23 via avideo driver 37. Other input devices may include a microphone 34connected through a suitable audio interface 35, or a physical hardwarekeyboard (not shown). Output devices may include at least one of thedisplay 32, or a projector display 36.

In addition to the display 32, the computing device 20 may include otherperipheral output devices, such as at least one speaker 38. Otherexternal input or output devices 39, such as a joystick, game pad,satellite dish, scanner or the like may be connected to the processingunit 21 through a USB port 40 and USB port interface 41, to the systembus 23. Alternatively, the other external input and output devices 39may be connected by other interfaces, such as a parallel port, game portor other port. The computing device 20 may further include or be capableof connecting to a flash card memory (not shown) through an appropriateconnection port (not shown). The computing device 20 may further includeor be capable of connecting with a network through a network port 42 andnetwork interface 43, and through wireless port 46 and correspondingwireless interface 47 may be provided to facilitate communication withother peripheral devices, including other computers, printers, and so on(not shown). It will be appreciated that the various components andconnections shown are examples and other components and means ofestablishing communication links may be used.

The computing device 20 may be primarily designed to include a userinterface. The user interface may include a character, a key-based, oranother user data input via the touch sensitive display 32. The userinterface may include using a stylus (not shown). Moreover, the userinterface is not limited to an actual touch-sensitive panel arranged fordirectly receiving input, but may alternatively or in addition respondto another input device such as the microphone 34. For example, spokenwords may be received at the microphone 34 and recognized.Alternatively, the computing device 20 may be designed to include a userinterface having a physical keyboard (not shown).

The device functional elements 50 are typically application specific andrelated to a function of the electronic device, and are coupled with thesystem bus 23 through an interface (not shown). The functional elementsmay typically perform a single well-defined task with little or no userconfiguration or setup, such as a refrigerator keeping food cold, a cellphone connecting with an appropriate tower and transceiving voice ordata information, a camera capturing and saving an image, orcommunicating with an implantable medical apparatus.

In certain instances, one or more elements of the thin computing device20 may be deemed not necessary and omitted. In other instances, one ormore other elements may be deemed necessary and added to the thincomputing device.

FIG. 2 and the following discussion are intended to provide a brief,general description of an environment in which embodiments may beimplemented. FIG. 2 illustrates an example embodiment of ageneral-purpose computing system in which embodiments may beimplemented, shown as a computing system environment 100. Components ofthe computing system environment 100 may include, but are not limitedto, a computing device 110 having a processor 120, a system memory 130,and a system bus 121 that couples various system components includingthe system memory to the processor 120. The system bus 121 may be any ofseveral types of bus structures including a memory bus or memorycontroller, a peripheral bus, and a local bus using any of a variety ofbus architectures. By way of example, and not limitation, sucharchitectures include Industry Standard Architecture (ISA) bus, MicroChannel Architecture (MCA) bus, Enhanced ISA (EISA) bus, VideoElectronics Standards Association (VESA) local bus, and PeripheralComponent Interconnect (PCI) bus, also known as Mezzanine bus.

The computing system environment 100 typically includes a variety ofcomputer-readable media products. Computer-readable media may includeany media that can be accessed by the computing device 110 and includeboth volatile and nonvolatile media, removable and non-removable media.By way of example, and not of limitation, computer-readable media mayinclude computer storage media. By way of further example, and not oflimitation, computer-readable media may include a communication media.

Computer storage media includes volatile and nonvolatile, removable andnon-removable media implemented in any method or technology for storageof information such as computer-readable instructions, data structures,program modules, or other data. Computer storage media includes, but isnot limited to, random-access memory (RAM), read-only memory (ROM),electrically erasable programmable read-only memory (EEPROM), flashmemory, or other memory technology, CD-ROM, digital versatile disks(DVD), or other optical disk storage, magnetic cassettes, magnetic tape,magnetic disk storage, or other magnetic storage devices, or any othermedium which can be used to store the desired information and which canbe accessed by the computing device 110. In a further embodiment, acomputer storage media may include a group of computer storage mediadevices. In another embodiment, a computer storage media may include aninformation store. In another embodiment, an information store mayinclude a quantum memory, a photonic quantum memory, or atomic quantummemory. Combinations of any of the above may also be included within thescope of computer-readable media.

Communication media may typically embody computer-readable instructions,data structures, program modules, or other data in a modulated datasignal such as a carrier wave or other transport mechanism and includeany information delivery media. The term “modulated data signal” means asignal that has one or more of its characteristics set or changed insuch a manner as to encode information in the signal. By way of example,and not limitation, communications media may include wired media, suchas a wired network and a direct-wired connection, and wireless mediasuch as acoustic, RF, optical, and infrared media.

The system memory 130 includes computer storage media in the form ofvolatile and nonvolatile memory such as ROM 131 and RAM 132. A RAM mayinclude at least one of a DRAM, an EDO DRAM, a SDRAM, a RDRAM, a VRAM,or a DDR DRAM. A basic input/output system (BIOS) 133, containing thebasic routines that help to transfer information between elements withinthe computing device 110, such as during start-up, is typically storedin ROM 131. RAM 132 typically contains data and program modules that areimmediately accessible to or presently being operated on by theprocessor 120. By way of example, and not limitation, FIG. 2 illustratesan operating system 134, application programs 135, other program modules136, and program data 137. Often, the operating system 134 offersservices to applications programs 135 by way of one or more applicationprogramming interfaces (APIs) (not shown). Because the operating system134 incorporates these services, developers of applications programs 135need not redevelop code to use the services. Examples of APIs providedby operating systems such as Microsoft's “WINDOWS” ® are well known inthe art.

The computing device 110 may also include other removable/non-removable,volatile/nonvolatile computer storage media products. By way of exampleonly, FIG. 2 illustrates a non-removable non-volatile memory interface(hard disk interface) 140 that reads from and writes for example tonon-removable, non-volatile magnetic media. FIG. 2 also illustrates aremovable non-volatile memory interface 150 that, for example, iscoupled to a magnetic disk drive 151 that reads from and writes to aremovable, non-volatile magnetic disk 152, or is coupled to an opticaldisk drive 155 that reads from and writes to a removable, non-volatileoptical disk 156, such as a CD ROM. Other removable/nonremovable,volatile/non-volatile computer storage media that can be used in theexample operating environment include, but are not limited to, magnetictape cassettes, memory cards, flash memory cards, DVDs, digital videotape, solid state RAM, and solid state ROM. The hard disk drive 141 istypically connected to the system bus 121 through a non-removable memoryinterface, such as the interface 140, and magnetic disk drive 151 andoptical disk drive 155 are typically connected to the system bus 121 bya removable non-volatile memory interface, such as interface 150.

The drives and their associated computer storage media discussed aboveand illustrated in FIG. 2 provide storage of computer-readableinstructions, data structures, program modules, and other data for thecomputing device 110. In FIG. 2, for example, hard disk drive 141 isillustrated as storing an operating system 144, application programs145, other program modules 146, and program data 147. Note that thesecomponents can either be the same as or different from the operatingsystem 134, application programs 135, other program modules 136, andprogram data 137. The operating system 144, application programs 145,other program modules 146, and program data 147 are given differentnumbers here to illustrate that, at a minimum, they are differentcopies.

A user may enter commands and information into the computing device 110through input devices such as a microphone 163, keyboard 162, andpointing device 161, commonly referred to as a mouse, trackball, ortouch pad. Other input devices (not shown) may include at least one of atouch sensitive display, joystick, game pad, satellite dish, andscanner. These and other input devices are often connected to theprocessing unit 120 through a user input interface 160 that is coupledto the system bus, but may be connected by other interface and busstructures, such as a parallel port, game port, or a universal serialbus (USB).

A display 191, such as a monitor or other type of display device orsurface may be connected to the system bus 121 via an interface, such asa video interface 190. A projector display engine 192 that includes aprojecting element may be coupled to the system bus. In addition to thedisplay, the computing device 110 may also include other peripheraloutput devices such as speakers 197 and printer 196, which may beconnected through an output peripheral interface 195.

The computing system environment 100 may operate in a networkedenvironment using logical connections to one or more remote computers,such as a remote computer 180. The remote computer 180 may be a personalcomputer, a server, a router, a network PC, a peer device, or othercommon network node, and typically includes many or all of the elementsdescribed above relative to the computing device 110, although only amemory storage device 181 has been illustrated in FIG. 2. The networklogical connections depicted in FIG. 2 include a local area network(LAN) and a wide area network (WAN), and may also include other networkssuch as a personal area network (PAN) (not shown). Such networkingenvironments are commonplace in offices, enterprise-wide computernetworks, intranets, and the Internet.

When used in a networking environment, the computing system environment100 is connected to the network 171 through a network interface, such asthe network interface 170, the modem 172, or the wireless interface 193.The network may include a LAN network environment, or a WAN networkenvironment, such as the Internet. In a networked environment, programmodules depicted relative to the computing device 110, or portionsthereof, may be stored in a remote memory storage device. By way ofexample, and not limitation, FIG. 2 illustrates remote applicationprograms 185 as residing on memory storage device 181. It will beappreciated that the network connections shown are examples and othermeans of establishing communication link between the computers may beused.

In certain instances, one or more elements of the computing device 110may be deemed not necessary and omitted. In other instances, one or moreother elements may be deemed necessary and added to the computingdevice.

FIG. 3 illustrates an example environment 200 in which embodiments maybe implemented. The environment includes a mammal 205, illustrated, forexample, by a human profile, a mammalian body part 210, illustrated astubular structure, and a system 220.

FIG. 4 illustrates additional details of the mammalian body part 210,including a region of interest 214, illustrated as regions of interest214A-214B of the mammalian body part, and including a landmarksubsurface feature, illustrated as landmark subsurface features216A-216C. In an embodiment, the region of interest includes an area orregion where a medical professional or patient has an interest,including a region for monitoring, for administration of a therapeuticagent, or for surgery or other procedure. View 4A of FIG. 4 illustratesthe body part 210 as a tubular structure having a cavity or lumen 211and an interior surface 212. View 4B of FIG. 4 illustrates a sectionview of the mammalian body part illustrated in View 4A after being cutalong line “A”-“A” and unrolled.

A first region of interest 214A of the mammalian body part 210 has aspatial relationship 215 to a second region of interest 214B of themammalian body part. In an embodiment, the first region of interest 214Aor the second region of interest 214B may be located on the surface 212,or may be subsurface of the mammalian body part. A first landmarksubsurface feature 216A has a first spatial relationship 217A to thefirst region of interest 214A. A second landmark subsurface feature 216Bhas a second spatial relationship 217B to the second region of interest214B. The first landmark subsurface feature 216A has a spatialrelationship 213C to the second landmark subsurface feature 216B. Athird landmark subsurface feature 216C has a spatial relationship 213Ato the first landmark subsurface feature, and has a spatial relationship213B to the second landmark subsurface feature 216B. For example, aspatial relationship may be expressed in Cartesian coordinates 219 x, y,and z. For example, a spatial relationship may be expressed incylindrical coordinates, or spherical coordinates (not shown).

For example, a mammalian body part 210 may include a tissue, lumen or aninternal organ of a mammal, such as by way of non-limiting example,heart, lung, bone, brain, muscle, esophagus, stomach, intestine, spleen,pancreas, kidney, liver, urinary bladder, vagina, fallopian tube,urethra, duodenum, colon, rectum, artery, vein, bronchus, or duct. In anembodiment, the mammalian body part may be machine differentiated fromanother body part of a mammal.

In an embodiment, the region of interest 214 of the mammalian body partmay include any tissue of the mammalian body part 210. For example, theregion of interest may include a portion of an interior surface 212 ofthe mammalian body part. For example, the region of interest may includea portion of an exterior surface of the mammalian body part. Forexample, the region of interest may include a subsurface region ofinterest of the mammalian body part. For example, the region of interestmay include a mammalian internal organ. For example, the region ofinterest may include an internal anatomical mammalian body part. Forexample, an internal anatomical mammalian body may include more than oneinternal organ. For example, the region of interest may include anexternal mammalian body part. For example, an external mammalian bodypart may include an ear, a nose, or a portion of skin. For example, theregion of interest may include a surface of a mammalian body part. Forexample, the region of interest of a surface of a mammalian body partmay include a surface of a cavity or lumen of a mammalian body part.

For example, the region of interest 214 of the surface 212 of amammalian body part 210 may include a surface defining a cavity or lumenof a mammalian body part. For example, the region of interest mayinclude a subsurface region of interest of a mammalian body part. Forexample, the region of interest may include a wall, membrane,endothelial, or epithelial layer of a surface of a mammalian body part.For example, the region of interest may include a wall, membrane, orepithelial layer defining a cavity or lumen of a mammalian body part.For example, the region of interest may include a region of interest ofa surface of an orifice, canal, cavity, or other hollow region of amammalian body part. For example, the region of interest may include aninterior surface of gastrointestinal organ or digestive organ of amammalian body part. For example, the region of interest may include aregion of interest of an interior surface of a colon of the mammal. Forexample, the region of interest may include a region of interest of aninterior surface of an air passageway of a mammalian body part.

In an embodiment, the landmark subsurface feature 216 of the mammalianbody part 210 includes a subsurface feature of the cavity or lumen 211of the mammalian body part that serves as a landmark. For example, thelandmark subsurface feature of a cavity or lumen of the mammalian bodypart may include a subsurface anatomical feature of a cavity or lumen ofthe mammalian body part. For example, the landmark subsurface feature ofa cavity or lumen of the mammalian body part may include a subsurfacevascular feature of a cavity or lumen of the mammalian body part. Forexample, the landmark subsurface feature of a cavity or lumen of themammalian body part may include a subsurface anomaly of a cavity orlumen of the mammalian body part. For example, the landmark subsurfacefeature of the mammalian body part may include a subsurface anatomicalfeature of the mammalian body part. For example, the landmark subsurfacefeature of the mammalian body part may include a subsurface vascularfeature of the mammalian body part. For example, the landmark subsurfacefeature of the mammalian body part may include a subsurface vessel,blood vessel, vascular structure, or a pattern presented by one or moreblood vessels of the mammalian body part. For example, the landmarksubsurface feature of the mammalian body part includes blood within asubsurface blood vessel of the mammalian body part. In an embodiment,the landmark subsurface feature of the mammalian body part may include afluid, or fluid contained within a subsurface feature of the mammalianbody part.

For example, the landmark subsurface feature 216 of the mammalian bodypart 210 may include a physical structure, nerve, void, border,component, tissue, structural feature, or density variation of themammalian body part. For example, a physical structure may include aduct, a bend or curve in a tubular structure, or an organ such as anappendix or colon. For example, a subsurface feature of the mammalianbody part may include a pattern presented by one or more features of themammalian body part. For example, the landmark subsurface feature of themammalian body part may include a fiducial formed by one or morejunctions between blood vessels, by blood vessel or nerves, by anglesbetween blood vessels at a junction or apparent intersection, relativepositions and angles between nearby junctions. For example, the landmarksubsurface feature of the mammalian body part may include relative sizesof two or more blood vessels, relative sizes of blood vessels atjunctions or nearby junctions, or branching in lungs. For example, asubsurface feature of the mammalian body part may include a normalsubsurface feature of the mammalian body part. For example, a normalsubsurface feature of the mammalian body part may include a usual,regular, or typical subsurface feature of the mammalian body part. Forexample, the landmark subsurface feature of the mammalian body part mayinclude an abnormal subsurface feature of the mammalian body part. Forexample, an abnormal subsurface feature of the mammalian body part mayinclude an unusual, irregular, or disease state subsurface feature ofthe mammalian body part. For example, an abnormal subsurface feature mayinclude a scar tissue, healed lesion, nodule, or encapsulated foreignobject. For example, the landmark subsurface feature of the mammalianbody part may include a landmark subsurface feature of the mammalianbody part that is machine distinguishable from another landmarksubsurface feature of the mammalian body part. For example, the landmarksubsurface feature of the mammalian body part may include a landmarksubsurface feature of the mammalian body part that is machinedifferentiable from another landmark subsurface feature of the mammalianbody part. For example, a computing machine is able to differentiatebetween first landmark subsurface feature 216A and second landmarksubsurface feature 216B, but may not able to distinguish or discern whythey are not the same.

Returning to FIG. 3, the environment 200 includes the system 220. Thesystem includes a receiver circuit 222. The receiver circuit isconfigured to receive data indicative of a region of interest of themammalian body part 210, such as the region of interest 214A of FIG. 4.

In an embodiment, the medical image includes a region of interest 214 ofa mammalian body part 210. In an embodiment, the medical image includesa selected region of interest of a mammalian body part. In anembodiment, the region of interest may be selected by a health careprovider during a colonoscopy, such as by the health care provideractivating a selector or a camera during the colonoscopy. The healthcare provider is illustrated as the person 296. The region of interestmay be selected for any reason, including a possible disease state,marking a point of interest to which a health care provider, such as anendoscopist, wants to return in the future, for example, to monitorprogression of disease or lack thereof. In an embodiment, the region ofinterest may be selected by a machine during a virtual colonoscopy, orin response to a virtual colonoscopy.

For example, “a medical image” may include an image created using atechnique or process, often for clinical purposes or medical science.For example, “a medical image” may include an image produced using atechnique or process of radiography, magnetic resonance imaging, nuclearmedicine, ultrasound, thermography, or tomography. For example, “amedical image” may include a two-dimensional medical image or athree-dimensional medical image. An aspect of a “medical image” mayinclude information or data providing positional information. Forexample, see GE Healthcare's website “Medcyclopaedia” at“http://www.medcyclopaedia.com/?tt_topic=” includes a library of medicalimages. (Accessed Aug. 16, 2011.)

For example, “a medical image that includes a region of interest” mayinclude information or data indicative of the region of interest of asurface of a mammalian body part. For example, the “medical image thatincludes a region of interest” may include information or dataindicative of the region of interest of a surface of a cavity or lumenof a mammalian body part. For example, the “medical image that includesa region of interest” may include information or data descriptive of theregion of interest of a mammalian body part.

For example, “a reference image” may be created using a technique orprocess to create an image providing positional information or datarelated to one or more landmark subsurface features of a mammalian bodypart. For example, “a reference image” may also provide positionalinformation or data related to one of more regions of interest, but maynot provide adequate resolution, definition, or granularity to beconsidered “a medical image.”

In an embodiment, the medical image may include a region of interest 214of a mammalian body part 210. For example, the medical image may includea two-dimensional medical image or a three-dimensional medical image.For example, the medical image may or may not include a medical imagevisualizable by the human eye. For example, the medical image mayinclude a medical image indicative of a region of interest of a cavityor lumen of a mammalian body part. For example, the medical image mayinclude a medical image indicative of a region of interest of a surfaceof a cavity or lumen of a mammalian body part. For example, a singleimage may include both the medical image and the reference image. Forexample, the medical image is acquired at substantially a same time asthe reference image. For example, the medical image is acquired atsubstantially different time from the acquisition of the referenceimage.

In an embodiment, the medical image may include a region of interest 214of a mammalian body part 210 acquired at substantially a same locationas a reference image that includes a landmark subsurface feature of themammalian body part. In an embodiment, the medical image may include aregion of interest of a mammalian body part acquired at substantially adifferent location as the reference image that includes a landmarksubsurface feature of the mammalian body part. In an embodiment, themedical image may include a region of interest of a mammalian body partacquired at substantially same spectra as the reference image thatincludes a landmark subsurface feature of the mammalian body part. In anembodiment, the medical image may include a region of interest of amammalian body part acquired at substantially different spectra as thereference image that includes a landmark subsurface feature of themammalian body part. In an embodiment, the medical image may include aregion of interest of a mammalian body part, and have an overlappingfield of view with the landmark digital image that includes a subsurfacefeature of the mammalian body part. For example, the medical image mayhave been acquired using at least one of a PET, x-ray, CAT, coherencetomography (CT) image, magnetic resonance imaging (MRI) image,fluoroscopy, fluorescence based imaging, or ultrasound based imagetechnology. For example, the medical image may have been acquired usingat least one of a visible light, near infrared light, infrared light,ultraviolet light, passive thermal, or active thermal based imaging.

In an embodiment, the receiver circuit 222 configured to receive amedical image that includes region of interest 214 of a mammalian bodypart 210 may include a receiver circuit configured to facilitate anacquisition of the medical image. In an embodiment, the receiver circuitmay facilitate an acquisition of the medical image by sending a signalto an image capture device instructing it to acquire the medical image.The signal may be responsive to a human-user initiated input or amachine initiated input. In an embodiment, the receiver circuit mayinclude a receiver circuit configured to facilitate a capture of themedical image.

In an embodiment, the medical image that includes a region of interest214 of a mammalian body part 210 may include a user-selected a region ofinterest of a mammalian body part. In an embodiment, the medical imagemay include information or data indicative of a region of interest of amammalian body part. The medical image acquired by a body-insertabledevice 280 while a portion of the body-insertable device was present ina cavity or lumen of the mammalian body part. For example, thebody-insertable device may include a wired or a wireless device. Forexample, the body-insertable device may include an endoscope,laparoscope, swallowable camera capsule, capsule endoscopic, orpill-type camera apparatus. For example, RF Systems Lab Ltd. located inNagano, Japan announced a capsule endoscope branded as Sayaka. TheSayaka is marketed as configured to capture medical images of the wholeinner surface of the digestive tract.http://www.rfamerica.com/sayaka/index.html (accessed Aug. 16, 2011). Forexample, Given Imaging Ltd. of Yoqneam, Israel, markets PillCam® forcapsule endoscopy of the esophagus and small bowel. For example, abody-insertable device may include an ingestible device. For example, abody-insertable device may include an injectable, implantable, orinsertable device.

In an embodiment, a medical image may include a medical image acquiredby a body-insertable device while a portion of the body-insertabledevice is present in a cavity or lumen of the mammalian body part 210.In an embodiment, the medical image may include a medical image acquiredby a body-insertable device while a distal end portion of thebody-insertable device is present in a cavity or lumen of the mammalianbody part. For example, the distal end portion of the body-insertabledevice may include a camera, effector, scalpel, biopsy device (such asrotational tissue-cutting razor, or ablation device.

In an embodiment, the medical image may be acquired by an ex vivo device290. In an embodiment, the ex vivo device may include a wired or awireless device. In an embodiment, the ex vivo device may include anx-ray, fluoroscope, near infrared (NIR), or ultrasound device. In anembodiment, the medical image may include a digital medical image thatincludes a region of interest of the mammalian body part. In anembodiment, the medical image may include an analog medical image thatincludes a region of interest of the mammalian body part.

In an embodiment, the receiver circuit 222 is configured to receive areference image that includes a landmark subsurface feature 216 of themammalian body part, such as the landmark subsurface feature 216A. Thelandmark subsurface feature 216 has a spatial relationship to the regionof interest 217, such as the spatial relationship 217A. The landmarksubsurface feature is of the body part 210 and not of a subsurfacefeature of another proximate mammalian body part. For example, if thebody part is a kidney, the landmark subsurface feature is a subsurfacefeature of the kidney and not of a feature of another body part, such asa spinal column. For example, the landmark subsurface feature mayinclude a landmark subsurface feature imageable by x-ray, fluoroscope,NIR, or ultrasound. For example, the landmark subsurface feature mayinclude a landmark subsurface feature distinguishable or unique fromanother landmark subsurface feature of the body part.

In an embodiment, the reference image may include a two-dimensional orthree-dimensional digital image that includes a landmark subsurfacefeature 216 of the mammalian body part 210. The landmark subsurfacefeature has a spatial relationship to the region of interest. Forexample, the landmark subsurface feature may include a landmarksubsurface feature having an indicated, determinable, estimable, orinferable spatial relationship to the region of interest. For example,the reference image of the landmark subsurface feature may include areference image that was acquired using at least two wavelengthenergies. For example, the wavelength energies may include visiblelight, near infrared, infrared, or ultrasound. For example, thereference image may include a selected landmark subsurface feature ofthe mammalian body part that has a spatial relationship to the region ofinterest. For example, the landmark subsurface feature may be selectedby a health care provider, such as an endoscopist, by a health careprovider according to the mammalian body part involved, or by a machine,such as during a virtual colonoscopy.

In an embodiment, the reference image may include a reference digitalimage that includes a landmark subsurface feature of the mammalian bodypart. For example, the reference image may include a reference analogimage that includes a landmark subsurface feature of the mammalian bodypart. In an embodiment, the reference image may include (i) a landmarksubsurface feature of the mammalian body part, and (ii) data indicativeof an environment when the reference image was acquired. The landmarksubsurface feature has a spatial relationship to the region of interest.For example, the data indicative of an environment may include at leastone of location data, date/time, temperature of the mammalian body part,or an off-set between the imaging device used to view or capture themedical image and the image capture device used to capture the referenceimage. For example, the data indicative of an environment may include pHof the mammalian body part, such as for example, a pH of the GI tract ora lumen. For example, the landmark subsurface may include a landmarksubsurface feature having a location, position, orientation, distance,directional, alignment, or axial relationship to the region of interest.For example, FIG. 4 illustrates an orientation of the landmarksubsurface feature 216B with respect to the region of interest 214B.Continuing with FIG. 3, for example, the landmark subsurface feature mayinclude a landmark subsurface feature described by blood carried in ablood vessel of the mammalian body part, the landmark subsurface featuredescribed by blood carried in a blood vessel having a spatialrelationship to the region of interest. For example, the landmarksubsurface feature may include a landmark subsurface feature describedby a pattern formed by a subsurface blood vessel, nerve, void, border,component, tissue, or structural feature of the mammalian body part, thepattern formed having a spatial relationship to the region of interest.

In an embodiment, the reference image may include an electronic signalindicative of a reference image that includes a landmark subsurfacefeature of the mammalian body part, the landmark subsurface featurehaving a spatial relationship to the region of interest. For example,the reference image may include a virtual landmark subsurface featureformed by at least two subsurface features of the mammalian body part,the virtual landmark subsurface feature having a spatial relationship tothe region of interest. For example, the landmark subsurface feature216B and the landmark subsurface feature 216C may be combined into avirtual landmark subsurface feature orientated toward the region ofinterest 214B.

In an embodiment, the reference image may include a landmark subsurfacefeature having a spatial relationship to the region of interest. Thereference image was acquired using at least one of a visible light, nearinfrared light, infrared light, ultraviolet light, ultrasound energy,passive thermal, or active thermal based imaging. In an embodiment, thereference image may include a landmark subsurface feature of themammalian body part. The landmark subsurface feature has a spatialrelationship to the region of interest. The reference image was acquiredusing at least one of a PET, x-ray, CAT, coherence tomography (CT)image, magnetic resonance imaging (MRI) image, fluoroscopy, fluorescencebased imaging, ultrasound, or microscopy imaging modality. In anembodiment, the reference image may include a landmark subsurfacefeature of the mammalian body part. The landmark subsurface feature hasa spatial relationship to the region of interest. The reference imagewas acquired using at least two wavelength energies. For example,wavelength energies may include visible light, near infrared, infrared,or ultrasound.

In an embodiment, the reference image may include a landmark subsurfacefeature of the mammalian body part. The landmark subsurface feature hasa spatial relationship to the region of interest. The reference imagethat includes indicia of the depth of the subsurface feature below asurface of the mammalian body part. In an embodiment, the referenceimage may be acquired by a body-insertable device while a portion of thebody-insertable device was present in a cavity or lumen of the mammalianbody part. The reference image that includes a landmark subsurfacefeature of the cavity or lumen of the mammalian body part having aspatial relationship to the region of interest. In an embodiment, thereference image may include a landmark subsurface feature of themammalian body part. The landmark subsurface feature has an indicated,determinable, estimable, or inferable spatial relationship to the regionof interest.

In an embodiment, the system 220 includes the registration circuit 224configured to register a location, position, orientation, distance,directional, alignment, or axial relationship of the region of interestrelative to the landmark subsurface feature of the mammalian body part.In an embodiment, the registration circuit may be configured to (i)extract the landmark subsurface feature from the reference image, and(ii) register a spatial relationship of the region of interest relativeto the extracted landmark subsurface feature. In an embodiment, theregistration circuit may be configured to (i) classify the landmarksubsurface feature, and (ii) register a spatial relationship of theregion of interest relative to the classified landmark subsurfacefeature. In an embodiment, the registration circuit may be configured to(i) recognize a pattern evidenced by the landmark subsurface feature,and (ii) register a spatial relationship of the region of interestrelative to the recognized pattern evidenced by the landmark subsurfacefeature. In an embodiment, the registration circuit may be configured to(i) select a pattern presented by the landmark subsurface feature assubstantially suitable for image registration, and (ii) register aspatial relationship of the region of interest relative to the selectedpattern presented by the landmark subsurface feature. In an embodiment,the registration circuit may be configured to register a spatialrelationship of the region of interest relative to at least two landmarksubsurface features of the mammalian body part. In an embodiment, theregistration circuit may be configured to register a spatialrelationship including an orientation of the region of interest relativeto the landmark subsurface feature of the mammalian body part. In anembodiment, the registration circuit may be configured to register aspatial relationship including an orientation of the landmark subsurfacefeature of the mammalian body part relative to the region of interest.In an embodiment, the registration circuit may be configured to registera spatial relationship of the landmark subsurface feature relative tothe region of interest. The registration includes an orientation of thelandmark subsurface feature and an orientation of the region ofinterest.

For example, “register” or “registration” may include systematicallyplacing separate images in a common frame of reference so that theinformation they contain can be optimally integrated or compared.Medical Image Registration, §1.1 (Joseph V. Hajnal and Derek L. G. Hill,editors (2001). For example, a registration of the region of interestand the landmark subsurface feature of the mammalian body part mayinclude registering a polyp of a colon to landmark blood vesselsubsurface feature. For example, a registration the region of interestand the landmark subsurface feature of the mammalian body part mayinclude registering the region of interest in reference, relative to, orwith regard to the landmark subsurface feature of the mammalian bodypart. For example, a registration of the region of interest and thelandmark subsurface feature of the mammalian body part may includetransforming them into one coordinate system. For example, aregistration of the region of interest and the landmark subsurfacefeature of the mammalian body part may include spatially relating theregion of interest in reference to the landmark subsurface feature ofthe mammalian body part. For example, the registering the region ofinterest 214A and the landmark subsurface feature 216A of the mammalianbody part 210 may indicate the spatial relationship 217A expressed as adistance, such as 2 mm, between a polyp of a colon and a landmark bloodvessel feature. In another example, a registration of the region ofinterest 214A and the landmark subsurface feature 216A of the mammalianbody part may indicate a spatial relationship 217A expressed in x, y,and z coordinates based upon a common point of reference. The commonpoint of reference may be the region of interest, the landmarksubsurface feature, or a third point of reference. In another example, aregistration of the region of interest 214A and the landmark subsurfacefeature 216A of the mammalian body part may indicate a spatialrelationship 217A expressed in x, y, and z coordinates. In an example, aregistration may include registering the region of interest 214A and thelandmark subsurface feature 216A of the mammalian body part in onecoordinate system.

The system 220 includes a computer-readable media 235 configured tomaintain informational data corresponding to the registration of theregion of interest and the landmark subsurface feature of the mammalianbody part 210. In an embodiment, the computer-readable media may bemanaged by a computer storage device 234. In an embodiment, thecomputer-readable media may include a computer-readable media configuredto maintain and to provide access to informational data corresponding tothe registration of the relationship of the region of interest relativeto the landmark subsurface feature of the mammalian body part. In anembodiment, the computer-readable media may include a tangiblecomputer-readable media. In an embodiment, the computer-readable mediamay include a communications media.

In an embodiment, the system 220 may further include an extractionengine 238 configured to extract the landmark subsurface feature fromthe reference image. An example of an extraction engine is described byDatacraft Co., Ltd. & Hokkaido University, Image Feature ExtractionEngine,http://www.igvpj.jp/cp2_en/common/rc/category00/image-feature-extraction-engin-1.html(last accessed Feb. 23, 2010). For example, the extraction engine may beconfigured to use a pattern recognition technique to extract informationfrom images. In an embodiment, the extraction engine may be configuredto use an artificial intelligence technique to extract information fromimages.

In an embodiment, the system 220 may include a communication circuit 242configured to output the informational data. In an embodiment, thecommunication circuit 242 may be configured to provide a notification toat least one of humans (such as the person 296), computers (such as thecomputing device 292), or systems (not illustrated). The notification isindicative of the registration of the spatial relationship of the regionof interest relative to the landmark subsurface feature of the mammalianbody part. For example, the system may include a processor 232. Forexample, the processor may perform or assist a performance of one ormore operations performed by the system. For example, the processor maybe implemented using the processing unit 21 described in conjunctionwith FIG. 1, or using the processor 120 described in conjunction withFIG. 2. For example, the system may include a thin computing device,such as the thin computing device 20 described in conjunction with FIG.1, or using the computing device 110 described in conjunction with FIG.2. For example, the thin computing device 20 or the computing device 110may implement one or more of the circuits of the system 220.

Returning to the environment 200 illustrated by FIGS. 3 and 4. In analternative embodiment, the system 220 includes the registration circuit224. The registration circuit is configured to register the region ofinterest 214 of the mammalian body part 210 and the landmark subsurfacefeature 216 of the mammalian body part. The registration is at leastpartially based on a spatial relationship 217 between the landmarksubsurface feature and the region of interest. In an embodiment, thelandmark subsurface feature has an indicated, known, determinable,estimable, or inferable spatial relationship to the region of interest.

The system 220 also includes the computer-readable media 235 configuredto maintain informational data corresponding to the registration of theregion of interest and the landmark subsurface feature of the mammalianbody part. In an embodiment, the system further includes thecommunication circuit 242 configured to output the informational datacorresponding to the registration of the spatial relationship of theregion of interest and the landmark subsurface feature of the mammalianbody part.

FIG. 5 illustrates an example operational flow 300. After a startoperation, the operation flow includes a medical image receivingoperation 310. The medical image receiving operation includes receivinga medical image that includes a region of interest of a mammalian bodypart. In an embodiment, the medical image receiving operation may beimplemented using the receiver circuit 222 described in conjunction withFIG. 3. In an alternative embodiment, the medical image receivingoperation may be implemented using the thin computing device 20described in conjunction with FIG. 1 or the computing device 110described in conjunction with FIG. 2. A reference image receivingoperation 350 includes receiving a reference image that includes alandmark subsurface feature of the mammalian body part. The landmarksubsurface feature has a spatial relationship to the region of interest.In an embodiment, the reference image receiving operation may beimplemented using the receiver circuit 222 described in conjunction withFIG. 3. In an alternative embodiment, the reference image receivingoperation may be implemented using the thin computing device 20described in conjunction with FIG. 1 or the computing device 110described in conjunction with FIG. 2. A registration operation 410includes registering the spatial relationship of the region of interestand the landmark subsurface feature of the mammalian body part. In anembodiment, the registration operation may be implemented using theregistration circuit 224 described in conjunction with FIG. 3. In analternative embodiment, the registration operation may be implementedusing the thin computing device 20 described in conjunction with FIG. 1or the computing device 110 described in conjunction with FIG. 2. Astorage operation 440 includes maintaining in a computer-readable mediainformational data corresponding to the registration of the spatialrelationship of the region of interest and the landmark subsurfacefeature of the mammalian body part. In an embodiment, the storageoperation may be implemented using the computer-readable media 235described in conjunction with FIG. 3. In an alternative embodiment, thestorage operation may be implemented using a computer-readable mediaassociated with the thin computing device 20 described in conjunctionwith FIG. 1 or a computer-readable media associated with the computingdevice 110 described in conjunction with FIG. 2. The operational flowincludes an end operation.

FIG. 6 illustrates alternative embodiments of the medical imagereceiving operation 310 of FIG. 5. The medical image receiving operation310 may include at least one additional embodiment. The at least oneadditional embodiment may include an operation 312, an operation 314, anoperation 316, an operation 318, an operation 322, an operation 324, anoperation 326, or an operation 328. The operation 312 includes receivinga medical image that includes a region of interest of a cavity or lumenof a mammalian body part. The operation 314 includes receiving a medicalimage that includes a region of interest of a surface of a cavity orlumen of a mammalian body part. The operation 316 includes receiving amedical image that includes a region of interest of a wall, membrane, orepithelial layer of a mammalian body part. The operation 318 includesreceiving a medical image that includes a region of interest of anorifice, canal, cavity, or hollow region of a mammalian body part. Theoperation 322 includes receiving a medical image that includesinformation or data indicative of a region of interest of a mammalianbody part. The operation 324 includes receiving a medical image thatincludes a region of interest of a mammalian body part, the medicalimage acquired using at least one of a PET, x-ray, CAT, coherencetomography (CT) image, magnetic resonance imaging (MRI) image,fluoroscopy, fluorescence based imaging, or ultrasound imaging modality.The operation 326 includes receiving a medical image that includes aregion of interest of a mammalian body part and that was acquired usingat least one of a visible light, near infrared light, infrared light,passive thermal, or active thermal imaging modality. The operation 328includes facilitating an acquisition of a medical image of a region ofinterest of a mammalian body part.

FIG. 7 illustrates alternative embodiments of the medical imagereceiving operation 310 of FIG. 5. The medical image receiving operation310 may include at least one additional embodiment. The at least oneadditional embodiment may include an operation 332, an operation 334, oran operation 336. The operation 332 includes acquiring a medical imagethat includes a region of interest of a mammalian body part. Theoperation 334 includes receiving a medical image that includes aselected region of interest of a mammalian body part. In an additionaloperation, both the medical image and the reference image are receivedfrom a single device (not illustrated). In an additional operation, themedical image is received from a first device and the reference image isreceived from a second device (not illustrated). In an embodiment, theoperation 336 includes receiving information or data indicative of aregion of interest of a mammalian body part that includes a landmarksubsurface feature of the mammalian body part, the landmark subsurfacefeature having a spatial relationship to the region of interest.

FIG. 8 illustrates alternative embodiments of the reference imagereceiving operation 350 of FIG. 5. The reference image receivingoperation 350 may include at least one additional embodiment. The atleast one additional embodiment may include an operation 352, anoperation 354, an operation 356, an operation 358, an operation 362, oran operation 364. The operation 352 includes receiving a two dimensionalor three dimensional reference image that includes a landmark subsurfacefeature of the mammalian body part. The landmark subsurface feature hasa spatial relationship to the region of interest. The operation 354includes receiving a reference image that includes a landmark subsurfacefeature of the mammalian body part. The landmark subsurface feature hasan indicated, determinable, estimable, or inferable spatial relationshipto the region of interest. The operation 356 includes receiving areference image that includes a landmark subsurface feature of themammalian body part. The reference image acquired using at least twowavelength energies and having a spatial relationship to the region ofinterest. The operation 358 includes receiving a reference image thatincludes a selected landmark subsurface feature of the mammalian bodypart. The landmark subsurface feature has a spatial relationship to theregion of interest. The operation 362 includes facilitating anacquisition of a reference image that includes a landmark subsurfacefeature of the mammalian body part. The landmark subsurface feature hasa spatial relationship to the region of interest. In an embodiment, thefacilitating an acquisition includes capturing a reference image thatincludes a landmark subsurface feature of the mammalian body part. Theoperation 364 includes receiving a reference image that includes alandmark subsurface feature of the mammalian body part, and receivingdata indicative of an environment when the reference image was acquired.The landmark subsurface feature has a spatial relationship to the regionof interest.

FIG. 9 illustrates alternative embodiments of the reference imagereceiving operation 350 of FIG. 5. The reference image receivingoperation may include at least one additional embodiment. The at leastone additional embodiment may include an operation 366, an operation368, an operation 372, an operation 374, an operation 376, or anoperation 378. The operation 366 includes receiving a reference imagethat includes a landmark subsurface feature of the mammalian body part.The landmark subsurface feature has a location, position, orientation,distance, directional, alignment, or axial relationship to the region ofinterest. The operation 368 includes receiving a reference image thatincludes a landmark subsurface feature defined by blood carried in ablood vessel of the mammalian body part. The landmark subsurface featurehas a spatial relationship to the region of interest. In an embodiment,the operation 372 includes receiving a reference image that includes apattern formed by a subsurface blood vessel, nerve, void, border,component, tissue, or structural feature of the mammalian body part, thepattern having a spatial relationship to the region of interest. In anembodiment, the operation 374 includes receiving an electronic signalindicative of a landmark subsurface feature of the mammalian body part.The landmark subsurface feature has a spatial relationship to the regionof interest. In an embodiment, the operation 376 includes a referenceimage that includes a composite landmark subsurface feature formed by atleast two subsurface features of the mammalian body part. The compositelandmark subsurface feature has a spatial relationship to the region ofinterest. In an embodiment, the operation 378 includes receiving areference image that includes a landmark subsurface feature of themammalian body part. The landmark subsurface feature has a spatialrelationship to the region of interest. The reference image was acquiredusing at least one of a visible light, near infrared light, infraredlight, ultraviolet light, ultrasound energy, passive thermal, or activethermal based imaging.

FIG. 10 illustrates alternative embodiments of the reference imagereceiving operation 350 of FIG. 5. The reference image receivingoperation may include at least one additional embodiment. The at leastone additional embodiment may include an operation 382, an operation384, an operation 386, an operation 388, an operation 392, or anoperation 394. The operation 382 includes receiving a reference imagethat includes a landmark subsurface feature of the mammalian body part.The landmark subsurface feature has a spatial relationship to the regionof interest. The reference image was acquired using at least one of aPET, x-ray, CAT, coherence tomography (CT) image, magnetic resonanceimaging (MRI) image, fluoroscopy, fluorescence based imaging,ultrasound, or microscopy imaging modality. The operation 384 includesreceiving a reference image that includes a landmark subsurface featureof the mammalian body part. The landmark subsurface feature has aspatial relationship to the region of interest. The reference image wasacquired using at least two wavelength energies. The operation 386includes receiving a reference image that includes a landmark subsurfacefeature of the mammalian body part. The reference image further includesindicia of a depth of the landmark subsurface feature below a surface ofthe mammalian body part. The landmark subsurface feature has a spatialrelationship to the region of interest. The operation 388 includesreceiving a reference image acquired by a body-insertable device while aportion of the body-insertable device was present in a cavity or lumenof the mammalian body part. The reference image includes a landmarksubsurface feature of the cavity or lumen of the mammalian body part hasa spatial relationship to the region of interest. The operation 392includes receiving a reference image that includes a landmark subsurfacefeature of the mammalian body part. The landmark subsurface feature anindicated, calculatable, determinable, estimable, or inferable spatialrelationship to the region of interest. The operation 394 includesreceiving a reference image that includes a landmark subsurface featureof a cavity or lumen of the mammalian body part. The landmark subsurfacefeature has a spatial relationship to the region of interest, and thereference image was acquired by a body-insertable device while a portionof the body-insertable device was present in the cavity or lumen of themammalian body part.

FIG. 11 illustrates alternative embodiments of the registrationoperation 410 of FIG. 5. The registration operation may include at leastone additional embodiment. The at least one additional embodiment mayinclude an operation 412, an operation 414, an operation 416, anoperation 418, an operation 422, or an operation 424. The operation 412includes registering a location, position, orientation, distance,directional, alignment, or axial relationship of the region of interestrelative to the landmark subsurface feature of the mammalian body part.The operation 414 includes the spatial relationship between the regionof interest and the landmark subsurface feature, and registering thespatial relationship of region of interest and the landmark subsurfacefeature of the mammalian body part in response to the determined spatialrelationship. The spatial relationship may include a two-dimensional ora three-dimensional spatial relationship. The operation 416 includesextracting the landmark subsurface feature from the reference image, andregistering the spatial relationship of the region of interest and theextracted landmark subsurface feature. The operation 418 includesclassifying the landmark subsurface feature, and registering the spatialrelationship of the region of interest and the classified landmarksubsurface feature. For example, the landmark subsurface feature may beclassified as a blood vessel, a component, or a structural feature. Theoperation 422 includes recognizing a pattern evidenced by the landmarksubsurface feature, and registering the spatial relationship of theregion of interest and the recognized pattern. The operation 424includes selecting a pattern presented by the landmark subsurfacefeature as suitable for image registration, and registering the spatialrelationship of the region of interest and the selected pattern.

FIG. 12 illustrates alternative embodiments of the registrationoperation 410 of FIG. 5. The registration operation may include at leastone additional embodiment. The at least one additional embodiment mayinclude an operation 426, an operation 428, an operation 432, or anoperation 434. The operation 426 includes registering the spatialrelationship of the region of interest relative to at least two landmarksubsurface features of the mammalian body part. The operation 428includes registering the spatial relationship including an orientationof the region of interest relative to the landmark subsurface feature ofthe mammalian body part. The operation 432 includes registering thespatial relationship including an orientation of the landmark subsurfacefeature of the mammalian body part and the region of interest. Theoperation 434 includes registering the spatial relationship including anorientation of the landmark subsurface feature of the mammalian bodypart and including an orientation of the region of interest.

FIG. 13 illustrates alternative embodiments of the operational flow 300of FIG. 5. The operational flow may include at least one additionalembodiment, such as an extraction operation 450. The extractionoperation includes extracting the landmark subsurface feature from thereference image. The extraction operation may include at least oneadditional embodiment. The at least one additional embodiment mayinclude an operation 452 or an operation 454. The operation 452 includesextracting the landmark subsurface feature from the reference imageusing a pattern recognition technique. The operation 454 includesextracting the landmark subsurface feature from the reference imageusing an artificial intelligence technique.

FIG. 14 illustrates alternative embodiments of the operational flow 300of FIG. 5. The operational flow may include at least one additionalembodiment 460. The at least one additional embodiment 460 may includean operation 462, an operation 464, an operation 466, or an operation468. The operation 462 includes providing electronic access to theinformational data. The operation 464 includes transforming theinformational data corresponding into a particular visual depiction ofthe registration of the spatial relationship of the region of interestand the landmark subsurface feature of the mammalian body part. Theoperation 466 includes outputting the informational data. The operation468 includes providing a notification that is at least partially basedon the informational data to at least one of a human, computer, orsystem.

FIG. 15 illustrates a computer program product 500. The computer programproduct includes a computer-readable media 510 bearing programinstructions 520. The program instructions, when executed by a processorof a computing device, cause the computing device to perform a process.The process includes receiving a medical image that includes a region ofinterest of a mammalian body part. The process includes receiving areference image that includes a landmark subsurface feature of themammalian body part. The landmark subsurface feature has a spatialrelationship to the region of interest. The process includes registeringthe region of interest and the landmark subsurface feature of themammalian body part. The process includes storing in anothercomputer-readable media operably coupled with the processorinformational data corresponding to the registration of the region ofinterest and the landmark subsurface feature of the mammalian body part.

In an embodiment, the process of the program instructions 520 mayinclude at least one additional process. The at least one additionalprocess may include a process 522 or a process 524. The process 522includes transforming the informational data into data useable inproviding a particular visual depiction of the region of interestrelative to the landmark subsurface feature of the mammalian body part.The process 524 includes providing a notification that is at leastpartially based on the informational data to at least one of a human,computer, or system. In an embodiment, the computer-readable media 510includes a tangible computer-readable media 526. In an embodiment, thecomputer-readable media includes a communications medium 528.

FIG. 16 illustrates an example system 600. The system includes means 610for receiving a medical image that includes a region of interest of amammalian body part. The system also includes means 620 for receiving areference image that includes a landmark subsurface feature of themammalian body part. The landmark subsurface feature has a spatialrelationship to the region of interest. The system further includesmeans 630 for registering the region of interest and the landmarksubsurface feature of the mammalian body part. The system also includesmeans 640 for persistently maintaining computer-readable informationaldata corresponding to the registration of the region of interest and thelandmark subsurface feature of the mammalian body part.

FIG. 17 illustrates an example operational flow 700. After a startoperation, the operational flow includes a registration operation 710.The registration operation includes registering a region of interest ofa mammalian body part and a landmark subsurface feature of the mammalianbody part. The registration is at least partially based on a spatialrelationship between the landmark subsurface feature and the region ofinterest. In an embodiment, the landmark subsurface has an indicated,known, determinable, estimable, or inferable spatial relationship to theregion of interest. For example, the registration operation may beimplemented using the registration circuit 224 described in conjunctionwith FIG. 3. For example, the registration operation may be implementedusing the thin computing device 20 described in conjunction with FIG. 1or the computing device 110 described in conjunction with FIG. 2. Astorage operation 720 includes maintaining in a computer-readable mediainformational data corresponding to the registration of the region ofinterest and the landmark subsurface feature of the mammalian body part.For example, the storage operation may be implemented using thecomputer-readable media 235 described in conjunction with FIG. 3. Forexample, the registration operation may be implemented using acomputer-readable media associated with the thin computing device 20described in conjunction with FIG. 1 or a computer-readable mediaassociated with the computing device 110 described in conjunction withFIG. 2. The operational flow includes an end operation.

In an embodiment, the operational flow may include at least oneadditional embodiment 730. The at least one additional embodiment mayinclude an operation 732, an operation 734, or an operation 736. Theoperation 732 includes outputting the informational data. The operation734 includes providing a notification that is at least partially basedon the informational data to at least one of a human, computer, orsystem. The operation 736 includes transforming the informational datainto a particular visual depiction of the registration of the region ofinterest and the landmark subsurface feature.

FIG. 18 illustrates an example environment 900. The example environmentincludes the mammal 205, illustrated by the human profile, the mammalianbody part 210, illustrated as tubular structure, and a system 920. Theenvironment may also include the body-insertable device 280, or the exvivo device 290.

The system includes a receiver circuit 922. The receiver circuit isconfigured to receive (i) a first medical image that includes a firstregion of interest of a mammalian body part, and (ii) a second medicalimage that includes a second region of interest of the mammalian bodypart. The receiver circuit is configured to receive (iii) a firstreference image that includes a first landmark subsurface feature of themammalian body part. The first landmark subsurface feature has a firstspatial relationship to the first region of interest. The receivercircuit is configured to receive (iv) a second reference image thatincludes a second landmark subsurface feature of the mammalian bodypart. The second landmark subsurface feature has a second spatialrelationship to the second region of interest. In an embodiment, thereceiver circuit may include at least two sub-circuits (notillustrated). For example, a first sub-circuit may be configured toreceive the first medical image and the second medical image. A secondsub-circuit may be configured to receive the first reference image andthe second reference image.

The system 920 includes a coordinate analysis circuit 924. Thecoordinate analysis circuit is configured to determine a common frame ofreference that is at least partially based on the first landmarksubsurface feature of the mammalian body part or the second landmarksubsurface feature of the mammalian body part. The word “or” as used inthis document should be understood to contemplate the possibilities ofincluding one of the terms, either of the terms, or both terms. Forexample, the phrase “A or B” will be understood to include thepossibilities of “A” or “B,” or “A and B.” For example, the coordinateanalysis circuit may be configured to determine a common frame ofreference that is at least partially based on the first landmarksubsurface feature of the mammalian body part. For example, thecoordinate analysis circuit may be configured to determine a commonframe of reference that is at least partially based on both the firstlandmark subsurface feature of the mammalian body part and the secondlandmark subsurface feature of the mammalian body part. For example, acommon frame of reference may include a Cartesian coordinate system thatwill serve to orient and locate objects in space, such as landmarksubsurface features or regions of interest. For example, a common frameof reference may relate to a physical or virtual object. For example, acommon frame of reference may use a parameter or set of parameters todetermine a location of the origin of a coordinate reference system.

The system 920 includes a registration circuit 926. The registrationcircuit is configured to register the first region of interest and thesecond region of interest at least partially based on the common frameof reference. For example, “registration” or image “registration” mayinclude systematically placing separate images in a common frame ofreference so that the information they contain can be optimallyintegrated or compared. See, Medical Image Registration, section 1.1,Joseph V. Hajnal & Derek L. G. Hill eds., (2001). For example, withreference to FIG. 4, the origin or zero point of the common frame ofreference determined by the coordinate analysis circuit 924 may be usedto register the region of interest 214A and the region of interest 214B.In an example, the origin or zero point of the common frame of referencemay be the region of interest 214A, and the region of interest 214B maybe registered by a coordinate system with reference to the region ofinterest 214A. For example, the common frame of reference determined bythe coordinate analysis circuit 924 may be a third point, such as thelandmark subsurface feature 216C. Continuing with reference to FIG. 18,the system 920 includes the computer-readable media 235 configured tomaintain informational data corresponding to the registration of thefirst region of interest and the second region of interest.

For example, the first landmark subsurface feature of the mammalian bodypart may be the same landmark subsurface feature as the second landmarksubsurface feature of the mammalian body part. For example, the firstlandmark subsurface feature and the second landmark subsurface featuremay be illustrated by the landmark subsurface feature 216A of FIG. 4.For example, the first landmark subsurface feature of the mammalian bodypart may be a substantially different subsurface feature than the secondlandmark subsurface feature of the mammalian body part. For example, thefirst landmark subsurface feature may be illustrated by the landmarksubsurface feature 216A and the second landmark subsurface feature maybe illustrated by the landmark subsurface feature 216B of FIG. 4.

In an embodiment, the first medical image may include a region ofinterest acquired by a body-insertable device while a portion of thebody-insertable device is present in a cavity or lumen of the mammalianbody part. For example, the first region of interest may include theregion of interest 214A of the cavity or lumen 211 of the mammalian bodypart 210, and the body-insertable device may include the body-insertabledevice 280. In an embodiment, the first medical image may include afirst region of interest acquired by a body-insertable device configuredfor examination or inspection of a cavity or lumen of a mammalian bodypart. The first medical image was acquired while a portion of thebody-insertable device was present in a cavity or lumen of the mammalianbody part. In an embodiment, the first medical image may include a firstmedical image that includes a first region of interest of a cavity orlumen of a mammalian body part. In an embodiment, the second medicalimage may include a second region of interest of the cavity or lumen ofthe mammalian body part. For example, the first region of interest mayinclude the region of interest 214A and the second region of interestmay include the region of interest 214B. In an embodiment, the firstmedical image may include a first region of interest of a surface of acavity or lumen of a mammalian body part. In an embodiment, the secondmedical image may include a second region of interest of the surface ofthe cavity or lumen of the mammalian body part. In an embodiment, thefirst medical image may include a first medical image acquired by an exvivo device and indicative of a first region of interest of a surface ofa cavity or lumen of a mammalian body part. For example, the ex vivodevice may include the ex vivo device 290. In an embodiment, the secondmedical image may be acquired by the ex vivo device and include a secondregion of interest of the surface of the cavity or lumen of themammalian body part. In an embodiment, the first medical image mayinclude a first medical image acquired by an ex vivo device andindicative of a first region of interest of a surface of a cavity orlumen of a mammalian body part. In an embodiment, the second medicalimage may include a second medical image acquired by the ex vivo deviceand indicative of a second region of interest of the surface of thecavity or lumen of the mammalian body part.

In an embodiment, the first reference image includes a first referenceimage acquired by a body-insertable device and that includes a firstlandmark subsurface feature of the mammalian body part. The firstlandmark subsurface feature has a first spatial relationship to thefirst region of interest. In an embodiment, the body-insertable devicemay include a body-insertable device 280 configured for examination orinspection of a cavity or lumen of a mammalian body part. In anembodiment, the second reference image includes a second reference imageacquired by the body-insertable device and includes a second landmarksubsurface feature of the mammalian body part. The second landmarksubsurface feature has a second spatial relationship to the secondregion of interest. In an embodiment, the first reference image includesa first reference image acquired by an ex vivo device and that includesa first landmark subsurface feature of the mammalian body part. Thefirst landmark subsurface feature has a first spatial relationship tothe first region of interest. In an embodiment, the second referenceimage includes a second reference image acquired by the ex vivo deviceand that includes a second landmark subsurface feature of the mammalianbody part. The second landmark subsurface feature has a second spatialrelationship to the second region of interest.

In an embodiment, the receiver circuit 922 includes a receiver circuitconfigured to receive (i) a first digital image representative of afirst region of interest of a mammalian body part, and (ii) a seconddigital image representative of a second region of interest of themammalian body part. The receiver circuit is configured to receive (iii)a first reference image representative of a first landmark subsurfacefeature of the mammalian body part, the first landmark subsurfacefeature having a first spatial relationship to the first region ofinterest, and (iv) a second reference image representative of a secondlandmark subsurface feature of the mammalian body part, the secondlandmark subsurface feature having a second spatial relationship to thesecond region of interest.

In an embodiment, the second reference image includes a second landmarksubsurface feature of the mammalian body part. The second landmarksubsurface feature has a second spatial relationship to the secondregion of interest, and the second landmark subsurface feature hasanother spatial relationship to the first landmark subsurface feature.For example and with reference to FIG. 4, the landmark subsurfacefeature 216B of the mammalian body part 210 has the spatial relationship217B to the region of interest 214B. The landmark subsurface feature216B also has a spatial relationship 213C to the landmark subsurfacefeature 216A.

In an embodiment, the coordinate analysis circuit 924 may be configuredto determine a common frame of reference and a coordinate system that isat least partially based on the first landmark subsurface feature or thesecond landmark subsurface feature. For example, the coordinate analysiscircuit may be configured to determine a common frame of referenceanchored in the first landmark subsurface feature or the second landmarksubsurface feature. For example, the coordinate analysis circuit may beconfigured to determine a coordinate reference system that is at leastpartially based on the first landmark subsurface feature or the secondlandmark subsurface feature.

In an embodiment, the registration circuit 926 may be configured toregister the first region of interest and the second region of interest.The registration is at least partially based on the determined commonframe of reference and on a spatial relationship between the firstlandmark subsurface feature and the second landmark subsurface feature.In an embodiment, the registration circuit may be configured to registera spatial relationship of the first region of interest relative to thesecond region of interest. The registration is at least partially basedon the determined common frame of reference. In an embodiment, theregistration circuit may be configured to register the first region ofinterest and the second region of interest in response to a coordinatereference system. The registration is at least partially based on thecommon frame of reference. In an embodiment, the registration circuitmay include a registration circuit configured to register the firstregion of interest and the second region of interest. The registrationis at least partially based on the common frame of reference, and theregistration includes an orientation of the first region of interestrelative to the second region of interest. In an embodiment, theregistration circuit may be configured to register the first region ofinterest and the second region of interest. The registration is at leastpartially based on the common frame of reference. The registrationincludes an orientation of the first region of interest relative to thesecond region of interest.

In an embodiment, the computer-readable media 235 includes acomputer-readable media configured to maintain and to provide electronicaccess to informational data corresponding to the registration of thefirst region of interest and the second region of interest. In anembodiment, the computer-readable media may include a computer-readablemedia configured to maintain informational data corresponding to theregistration, and informational data corresponding to the determinedcommon frame of reference. In an embodiment, the computer-readable mediamay include a computer storage device 234 having the computer-readablemedia 235, and configured to maintain informational data correspondingto the registration of the first region of interest and the secondregion of interest.

In an embodiment, the system 920 includes a communication circuit 942configured to output the informational data. In an embodiment, thecommunication circuit may be configured to provide a notification thatis at least partially based on the informational data to at least one ofa human, computer, or system. In an embodiment, the system includes theprocessor 232.

FIG. 19 illustrates an example operational flow 1000. After a startoperation, the operational flow includes a first reception operation1010. The first reception operation includes receiving a first medicalimage that includes a first region of interest of a mammalian body part.A second reception operation 1020 includes receiving a second medicalimage that includes a second region of interest of the mammalian bodypart. A third reception operation 1030 includes receiving a firstreference image that includes a first landmark subsurface feature of themammalian body part. The first landmark subsurface feature has a firstspatial relationship to the first region of interest. A fourth receptionoperation 1040 includes receiving a second reference image that includesa second landmark subsurface feature of the mammalian body part. Thesecond landmark subsurface feature has a second spatial relationship tothe second region of interest. For example, at least one of the first,second, third, or fourth reception operations may be implemented usingthe receiver circuit 922 described in conjunction with FIG. 18. Areference operation 1050 includes determining a common frame ofreference that is at least partially based on the first landmarksubsurface feature of the mammalian body part or the second landmarksubsurface feature of the mammalian body part. For example, thereference operation may be implemented using the coordinate analysiscircuit 924 described in conjunction with FIG. 18. A registrationoperation 1060 includes registering the first region of interest and thesecond region of interest at least partially based on the common frameof reference. For example, the registration operation may be implementedusing the registration circuit 926 described in conjunction with FIG.18. A storage operation 1070 includes maintaining in a computer-readablemedia informational data corresponding to the registration of the firstregion of interest and the second region of interest. For example, thestorage operation may be implemented using the computer-readable media235 described in conjunction with FIG. 18. The operational flow includesan end operation.

FIG. 20 illustrates an alternative embodiment of the operational flow1000 of FIG. 19. In an embodiment, the first reception operation 1010includes a first reception operation 1011 and the second receptionoperation 1020 includes a second reception operation 1021. The firstreception operation 1011 includes receiving a first medical image thatincludes a first region of interest of a cavity or lumen of a mammalianbody part. The second reception operation 1021 includes receiving asecond medical image that includes a second region of interest of thecavity or lumen of the mammalian body part. In an embodiment, the firstreception operation 1010 includes a first reception operation 1012 andthe second reception operation 1020 includes a second receptionoperation 1022. The first reception operation 1012 includes receiving afirst medical image that includes a first region of interest of asurface of a cavity or lumen of a mammalian body part. The secondreception operation 1022 includes receiving a second medical image thatincludes a second region of interest of the surface of the cavity orlumen of the mammalian body part.

FIG. 21 illustrates an alternative embodiment of the first receptionoperation 1010 of FIG. 19. The first reception operation may include atleast one additional embodiment. The at least one additional embodimentincludes an operation 1015, an operation 1016, an operation 1017, or anoperation 1018. The operation 1015 includes receiving a first medicalimage that includes a first region of interest of a mammalian body part,the first medical image acquired using at least one of a PET, x-ray,CAT, coherence tomography (CT) image, magnetic resonance imaging (MRI)image, fluoroscopy, fluorescence based imaging, ultrasound, ormicroscopy imaging modality. The operation 1016 includes receiving auser-acquisition-initiated first medical image that includes a firstregion of interest of a mammalian body part. For example, the user mayinclude a human user, such as the person 296 illustrated in FIG. 18, ora machine user (not illustrated). The operation 1017 includes receivinga first medical image that includes a first region of interest of amammalian body part. The first medical image was acquired by abody-insertable device while a portion of the body-insertable device waspresent in a cavity or lumen of the mammalian body part. The operation1018 includes receiving a first medical image that includes a firstregion of interest of a mammalian body part. The first medical image wasacquired by an ex vivo device.

FIG. 22 illustrates an alternative embodiment of the operational flow1000 of FIG. 19. In an embodiment, the third reception operation 1030may include at least one additional embodiment. The at least oneadditional embodiment includes an operation 1015, an operation 1016, anoperation 1017, or an operation 1018. The at least one additionalembodiment may include an operation 1031, an operation 1032, anoperation 1033, an operation 1034, or an operation 1035. The operation1031 includes receiving a first two-dimensional or three-dimensionalreference image that includes a first landmark subsurface feature of themammalian body part. The first landmark subsurface feature has a firstspatial relationship to the first region of interest. The operation 1032includes receiving a first reference image that includes a firstlandmark subsurface feature of the mammalian body part. The firstlandmark subsurface feature has an indicated, determinable, estimable,or inferable first spatial relationship to the first region of interest.The operation 1033 includes receiving a first reference image thatincludes a first landmark subsurface feature of the mammalian body part,and receiving data indicative of an environment when the first referenceimage was acquired. The first landmark subsurface feature has a firstspatial relationship to the first region of interest. The operation 1034includes receiving a first reference image that includes a firstlandmark subsurface feature of the mammalian body part. The firstlandmark subsurface feature has a first spatial relationship to thefirst region of interest, and the first reference image was acquired bya body-insertable device while a portion of the body-insertable devicewas present in a cavity or lumen of the mammalian body part. Theoperation 1035 includes receiving a first reference image that includesa first landmark subsurface feature of the mammalian body part. Thefirst landmark subsurface feature has a first spatial relationship tothe first region of interest, and the first reference image was acquiredby an ex vivo device.

FIG. 23 illustrates an alternative embodiment of the operational flow1000 of FIG. 19. In an embodiment, the third reception operation 1030includes a third reception operation 1036 and the fourth receptionoperation 1040 includes a fourth reception operation 1041. The thirdreception operation 1036 includes receiving a first reference image thatincludes a first landmark subsurface feature of the mammalian body part.The first landmark subsurface feature has a first spatial relationshipto the first region of interest. The fourth reception operation 1041includes receiving a second reference image that includes a secondlandmark subsurface feature of the mammalian body part. The secondlandmark subsurface feature has a second spatial relationship to thesecond region of interest, and the second subsurface feature further hasanother spatial relationship to the first subsurface feature.

FIG. 24 illustrates an alternative embodiment of the reference operation1050 of FIG. 19. The reference operation may include at least oneadditional embodiment. The at least one additional embodiment mayinclude an operation 1051, an operation 1052, or an operation 1053. Theoperation 1051 includes determining a common frame of reference and acoordinate system that is at least partially based on the first landmarksubsurface feature of the mammalian body part or the second landmarksubsurface feature of the mammalian body part. The operation 1052includes determining a common frame of reference that is at leastpartially anchored in the first landmark subsurface feature of themammalian body part or the second landmark subsurface feature of themammalian body part. The operation 1053 includes determining acoordinate reference system that is at least partially based on thefirst landmark subsurface feature of the mammalian body part or thesecond landmark subsurface feature of the mammalian body part.

FIG. 25 illustrates an alternative embodiment of the registrationoperation 1060 of FIG. 19. The registration operation may include atleast one additional embodiment. The at least one additional embodimentmay include an operation 1061, an operation 1062, an operation 1063, anoperation 1064, an operation 1065, or an operation 1066. The operation1061 includes registering the first region of interest and the secondregion of interest. The registering is at least partially based on thedetermined common frame of reference and on a spatial relationship ofthe first landmark subsurface feature and the second landmark subsurfacefeature. The operation 1062 includes registering the first region ofinterest relative to the second region of interest. The registering isat least partially based on the common frame of reference. The operation1063 includes registering a spatial relationship of the first region ofinterest relative to the second region of interest. The registering isat least partially based on the common frame of reference. The operation1064 includes registering a location, position, orientation, distance,directional, alignment, or axial relationship. The registering is atleast partially based on the common frame of reference. The operation1065 includes determining a spatial relationship between the firstregion of interest and the second region of interest. The operation 1065also includes registering the first region of interest and the secondregion of interest at least partially based on the common frame ofreference. In an embodiment, the determined spatial relationship mayinclude a determined two-dimension or a determined three-dimensionalrelationship. The operation 1066 includes registering an orientation ofthe first region of interest relative to the first landmark subsurfacefeature, registering an orientation of the second region of interestrelative to the second landmark subsurface feature, and registering thefirst region of interest and the second region of interest. Theregistering is at least partially based on the common frame ofreference.

FIG. 26 illustrates an alternative embodiment of the storage operation1070 of FIG. 19. The storage operation may include at least oneadditional embodiment, such as an operation 1071. The operation 1071includes maintaining in a computer-readable media informational datacorresponding to the registration of the first region of interest andthe second region of interest, and providing electronic access to theinformational data.

FIG. 27 illustrates an alternative embodiment of the operational flow1000 of FIG. 19. In an embodiment, the operational flow may include atleast one additional embodiment 1080. The at least one additionalembodiment may include an operation 1081, an operation 1082, anoperation 1083, an operation 1084, or an operation 1085. The operation1081 includes extracting the first landmark subsurface feature from thefirst reference image, and extracting the second landmark subsurfacefeature from the second reference image. In an embodiment, the operation1081 may be implemented using the extraction engine 238 described inconjunction with FIG. 3. The operation 1082 includes transforming theinformational data into a particular visual depiction of theregistration the first region of interest and the second region ofinterest. For example, the operation 1082 may be implemented using thecommunication circuit 242, and the particular visual depiction may bedisplayed on the screen 294 of the computing device 292 to the person296 as described in conjunction with FIG. 3. The operation 1083 includestransforming the informational data into a particular visual depictionof the spatial relationship of the first region of interest to thesecond region of interest. For example, the operation 1083 may beimplemented using the communication circuit 242 described in conjunctionwith FIG. 3. In an embodiment, the operation 1084 includes outputtingthe informational data. For example, the operation 1084 may beimplemented using the communication circuit 242 described in conjunctionwith FIG. 3. In an embodiment, the operation 1085 includes providing anotification that is at least partially based on the informational datato at least one of a human, computer, or system. For example, theoperation 1085 may be implemented using the communication circuit 242,and the notification may be displayed on the screen 294 of the computingdevice 292 to the person 296 as described in conjunction with FIG. 3.

FIG. 28 illustrates an example computer program product 1100. Thecomputer program product includes computer-readable media 1110 bearingprogram instructions 1120 which, when executed by a processor of acomputing device, cause the computing device to perform a process. Theprocess includes receiving a first medical image that includes a firstregion of interest of a mammalian body part. The process includesreceiving a second medical image that includes a second region ofinterest of the mammalian body part. The process includes receiving afirst reference image that includes a first landmark subsurface featureof the mammalian body part. The first landmark subsurface feature has afirst spatial relationship to the first region of interest. The processincludes receiving a second reference image that includes a secondlandmark subsurface feature of the mammalian body part. The secondlandmark subsurface feature has a second spatial relationship to thesecond region of interest. The process includes determining a commonframe of reference at least partially based on the first landmarksubsurface feature of the mammalian body part or the second landmarksubsurface feature of the mammalian body part. The process includesregistering the first region of interest and the second region ofinterest at least partially based on the common frame of reference. Theprocess includes storing informational data corresponding to theregistration of the first region of interest and the second region ofinterest in another computer-readable media operably coupled with theprocessor.

In an embodiment, the registering process includes 1122 registering thefirst region of interest and the second region of interest. Theregistration is at least partially based on the determined common frameof reference and on a spatial relationship of the first landmarksubsurface feature and the second landmark subsurface feature. In anembodiment, the process includes 1124 transforming the informationaldata into a signal usable in providing a particular visual depiction ofthe spatial relationship of the first region of interest relative to thesecond region of interest.

In an embodiment, the computer-readable media 1110 includes a tangiblecomputer-readable media 1112. In an embodiment, the computer-readablemedia includes a communications medium 1114.

FIG. 29 illustrates an example system 1200. The system includes means1210 for receiving a first medical image that includes a first region ofinterest of a mammalian body part. The system includes means 1220 forreceiving a second medical image that includes a second region ofinterest of the mammalian body part. The system includes means 1230 forreceiving a first reference image that includes a first landmarksubsurface feature of the mammalian body part. The first landmarksubsurface feature has a first spatial relationship to the first regionof interest. The system includes means 1240 for receiving a secondreference image that includes a second landmark subsurface feature ofthe mammalian body part. The second landmark subsurface feature has asecond spatial relationship to the second region of interest. The systemincludes means 1250 for determining a common frame of reference that isat least partially based on the first landmark subsurface feature of themammalian body part or the second landmark subsurface feature of themammalian body part. The system includes means 1260 for registering thefirst region of interest and the second region of interest that is atleast partially based on the common frame of reference. The systemincludes means 1270 for persistently maintaining computer-readableinformational data corresponding to the registration of the first regionof interest and the second region of interest.

Returning to FIG. 18, an alternative embodiment of the example system920 is also illustrated by FIG. 18. In the alternative embodiment, theexample system includes the coordinate analysis circuit 924 configuredto determine a common frame of reference. The common frame of referenceis determined at least partially based on a first landmark subsurfacefeature of the mammalian body part 210 or a second landmark subsurfacefeature of the mammalian body part. The first landmark subsurfacefeature has a first spatial relationship to a first region of interestof the mammalian body part, and the second landmark subsurface featurehas a second spatial relationship to a second region of interest of themammalian body part. In an embodiment, the system may include theregistration circuit 926 configured to register the first region ofinterest and the second region of interest at least partially based onthe common frame of reference. In an embodiment, the system may includethe computer-readable media 235 configured to maintain informationaldata corresponding to the registration of the first region of interestrelative to the second region of interest.

In an embodiment of the alternative embodiment, the coordinate analysiscircuit 924 is configured to determine a common frame of reference atleast partially based on a first landmark subsurface feature of amammalian body part or a second landmark subsurface feature of themammalian body part. The first landmark subsurface feature has a firstspatial relationship to a first region of interest of a cavity or lumenof the mammalian body part, and the second landmark subsurface featurehas a second spatial relationship to a second region of interest of thecavity or lumen of the mammalian body part. In an embodiment of thealternative embodiment, the coordinate analysis circuit is configured todetermine a common frame of reference at least partially based on afirst landmark subsurface feature of a cavity or lumen of a mammalianbody part or a second landmark subsurface feature of the cavity or lumenof the mammalian body part. The first landmark subsurface feature has afirst spatial relationship to a first region of interest of a surface ofthe cavity or lumen of the mammalian body part, and the second landmarksubsurface feature has a second spatial relationship to the secondregion of interest of the surface of the cavity or lumen of themammalian body part.

In an embodiment of the alternative embodiment, the registration circuit926 is configured to register the first region of interest and thesecond region of interest. The registration is at least partially basedon the determined common frame of reference and on a spatialrelationship of the first landmark subsurface feature and the secondlandmark subsurface feature.

In an embodiment of the alternative embodiment, the system includes thecommunication circuit 942. The communication circuit is configured tooutput the informational data. For example, the communication circuitmay be configured to provide a notification that is at least partiallybased on the informational data to at least one of a human, computer, orsystem.

In an embodiment of the alternative embodiment, the system includes thereceiver circuit 922. The receiver circuit is configured to receive afirst medical image that includes the first region of interest of themammalian body part, and a second medical image that includes the secondregion of interest of the mammalian body part. In an embodiment, thereceiver circuit is configured to receive a first reference image thatincludes the first landmark subsurface feature of the mammalian bodypart, and a second reference image that includes the second landmarksubsurface feature of the mammalian body part.

FIG. 30 illustrates an example operational flow 1200. The operationalflow includes a start operation. The operational flow includes areference operation 1210. The reference operation includes determining acommon frame of reference at least partially based on a first landmarksubsurface feature of a mammalian body part or a second landmarksubsurface feature of the mammalian body part. The first landmarksubsurface feature has a first spatial relationship to a first region ofinterest of the mammalian body part, and the second landmark subsurfacefeature has a second spatial relationship to a second region of interestof the mammalian body part. For example, the reference operation may beimplemented using the coordinate analysis circuit 924 described inconjunction with FIG. 18. The operational flow includes a registrationoperation 1220. The registration operation includes registering thefirst region of interest and the second region of interest at leastpartially based on the common frame of reference. In an embodiment, theregistration operation may be implemented using the registration circuit926 described in conjunction with FIG. 18. For example, the registrationoperation may be implemented using the thin computing device 20described in conjunction with FIG. 1 or the computing device 110described in conjunction with FIG. 2. The operational flow includes astorage operation 1230. The storage operation includes maintaining in acomputer-readable media informational data corresponding to theregistration of the first region of interest and the second region ofinterest at least. For example, the storage operation may be implementedusing the computer-readable media 235 described in conjunction with FIG.3. For example, the storage operation may be implemented using acomputer-readable media associated with the thin computing device 20described in conjunction with FIG. 1 or a computer-readable mediaassociated with the computing device 110 described in conjunction withFIG. 2. The operational flow includes an end operation.

FIG. 31 illustrates an alternative embodiment of the reference operation1210 described in conjunction with FIG. 30. In an alternativeembodiment, the reference operation may include at least one additionalembodiment. The at least one additional embodiment may include anoperation 1212 or an operation 1214. The operation 1212 includesdetermining a common frame of reference that is at least partially basedon a first landmark subsurface feature of a mammalian body part or asecond landmark subsurface feature of the mammalian body part. The firstlandmark subsurface feature has a first spatial relationship to a firstregion of interest of a cavity or lumen of the mammalian body part. Thesecond landmark subsurface feature has a second spatial relationship toa second region of interest of the cavity or lumen of the mammalian bodypart. The operation 1214 includes determining a common frame ofreference that is at least partially based on a first landmarksubsurface feature of a cavity or lumen of a mammalian body part or asecond landmark subsurface feature of the cavity or lumen of themammalian body part. The first landmark subsurface feature has a firstspatial relationship to a first region of interest of the cavity orlumen of the mammalian body part. The second landmark subsurface featurehas a second spatial relationship to the second region of interest ofthe cavity or lumen of the mammalian body part.

FIG. 32 illustrates an alternative embodiment of the operational flow1200 described in conjunction with FIG. 30. In an alternativeembodiment, the operational flow may include at least one additionalembodiment. The at least one additional embodiment may include anoperation 1241, an operation 1245, or an operation 1246. The operationalflow 1241 includes electronically outputting the informational data. Inan embodiment, the operational flow 1241 may include at least oneadditional embodiment, such as an operation 1242. The operation 1242includes electronically providing a notification that is at leastpartially based on the informational data to at least one of a human,computer, or system. The operation 1245 includes receiving a firstmedical image that includes the first region of interest of themammalian body part, and a second medical image that includes the secondregion of interest of the mammalian body part. The operation 1246includes receiving a first reference image that includes the firstlandmark subsurface feature of the mammalian body part, and a secondreference image that includes the second landmark subsurface feature ofthe mammalian body part.

FIG. 33 illustrates an example computer program product 1300. Thecomputer program product includes a computer-readable media 1310 bearingprogram instructions 1320 which, when executed by a processor of acomputing device, cause the computing device to perform a process. Theprocess includes determining a common frame of reference that is atleast partially based on a first landmark subsurface feature of amammalian body part or a second landmark subsurface feature of themammalian body part. The first landmark subsurface feature has a firstspatial relationship to a first region of interest of the mammalian bodypart. The second landmark subsurface feature has a second spatialrelationship to a second region of interest of the mammalian body part.The process includes registering the first region of interest and thesecond region of interest at least partially based on the common frameof reference. The process includes storing in another computer-readablemedia operably coupled with the processor informational datacorresponding to the registration of the first region of interest andthe second region of interest. In an embodiment, the registering mayinclude 1322 registering the first region of interest and the secondregion of interest. The registration is at least partially based on thedetermined common frame of reference and on a spatial relationship ofthe first landmark subsurface feature relative to the second landmarksubsurface feature. In an embodiment, the process may include 1330transforming the informational data into signal usable in providing aparticular visual depiction of the registration of the first region ofinterest and the second region of interest.

In an embodiment, the computer-readable media 1310 includes a tangiblecomputer-readable media 1312. In an embodiment, the computer-readablemedia includes a communications medium 1314.

FIG. 34 illustrates an example system 1400. The system includes means1410 for determining a common frame of reference at least partiallybased on a first landmark subsurface feature of a mammalian body part ora second landmark subsurface feature of the mammalian body part. Thefirst landmark subsurface feature has a first spatial relationship to afirst region of interest of the mammalian body part, and the secondlandmark subsurface feature has a second spatial relationship to asecond region of interest of the mammalian body part. The systemincludes means 1420 for registering the first region of interestrelative to the second region of interest that is at least partiallybased on the common frame of reference. The system includes means 1430for persistently maintaining computer-readable informational datacorresponding to the registration of the first region of interest andthe second region of interest.

FIG. 35 illustrates an example environment 1500. The environmentincludes the mammalian body part 210 of the mammal 205. A system 1520includes a coordinate analysis circuit 1524 configured to determine acommon frame of reference at least partially based on a landmarksubsurface feature of a mammalian body part has at least two landmarksubsurface features and at least two regions of interest. Each landmarksubsurface feature of at least two landmark subsurface features has arespective spatial relationship to a respective region of interest ofthe at least two regions of interest. The system includes a registrationcircuit 1526 configured to register the respective regions of interestof a mammalian body part. The registration is at least partially basedon the common frame of reference. The system includes thecomputer-readable media 235 configured to maintain informational datacorresponding to the respective registered regions of interest.

In an embodiment of the system 1520, the coordinate analysis circuit1524 may include a coordinate analysis circuit configured to determine acommon frame of reference at least partially based on a landmarksubsurface feature of a cavity or lumen of a mammalian body part. Thecavity or lumen of the mammalian body part has at least two landmarksubsurface features and at least two regions of interest. Each landmarksubsurface feature of at least two landmark subsurface features has arespective spatial relationship to a respective region of interest ofthe at least two regions of interest. In an embodiment, the coordinateanalysis circuit 1524 may include a coordinate analysis circuitconfigured to determine a common frame of reference at least partiallybased on a landmark subsurface feature of a cavity or lumen of amammalian body part. The cavity or lumen of the mammalian body part hasat least two landmark subsurface features and at least two regions ofinterest of a surface of the cavity or lumen. Each landmark subsurfacefeature of at least two landmark subsurface features has a respectivespatial relationship to a respective region of interest of the at leasttwo regions of interest. In an embodiment, the coordinate analysiscircuit may include a coordinate analysis circuit configured todetermine a common frame of reference and a coordinate system at leastpartially based on a landmark subsurface feature of a mammalian bodypart. The mammalian body part has at least two landmark subsurfacefeatures and at least two regions of interest. Each landmark subsurfacefeature of at least two landmark subsurface features has a respectivespatial relationship to a respective region of interest of the at leasttwo regions of interest. In an embodiment, the coordinate analysiscircuit may include a coordinate analysis circuit configured todetermine a common frame of reference anchored in a landmark subsurfacefeature of a mammalian body part has at least two landmark subsurfacefeatures and at least two regions of interest. Each landmark subsurfacefeature of at least two landmark subsurface features has a respectivespatial relationship to a respective region of interest of the at leasttwo regions of interest.

In an embodiment, the registration circuit 1526 may include aregistration circuit configured to register the respective regions ofinterest of a mammalian body part. The registration is at leastpartially based on the determined common frame of reference and on aspatial relationship among each landmark subsurface feature of at leasttwo landmark subsurface features. In an embodiment, the registrationcircuit may include a registration circuit configured to register aspatial relationship of the respective regions of interest of amammalian body part with respect to each other region of interest of theat least two regions of interest. The registration is at least partiallybased on the common frame of reference. In an embodiment, theregistration circuit may include a registration circuit configured toregister the respective regions of interest of a mammalian body part.The registration includes an orientation of the respective regions ofinterest. The registration is at least partially based on the commonframe of reference.

In an embodiment, the computer-readable media 235 may include acomputer-readable media configured to maintain informational datacorresponding to the respective registered regions of interest, andcorresponding to the determined common frame of reference.

In an embodiment, the system 1520 may include the communication circuit1542 configured to output the informational data. In an embodiment, thesystem may include a communication circuit configured to provide anotification that is at least partially based on the informational datato at least one of a human, computer, or system. In an embodiment, thesystem may include the processor 232. In an embodiment, the system mayinclude an extraction engine 1538. The extraction engine is configuredto extract a landmark subsurface feature or a region of interest from adigital image. In an embodiment, the system may include a receivercircuit 1522 configured to receive at least two medical images. Eachmedical image of the at least two medical images includes a respectiveregion of interest of the mammalian body part. In an embodiment, thesystem may include a receiver circuit configured to receive at least tworeference images. Each reference image of the at least two referenceimages includes a respective landmark subsurface feature of themammalian body part. Each landmark subsurface feature has a spatialrelationship to a respective region of interest included in a medicalimage of the at least two medical images.

FIG. 36 illustrates an example operational flow 1600. The operationalflow includes a start operation. The operational flow includes areference operation 1610. The reference operation includes determining acommon frame of reference that is at least partially based on a landmarksubsurface feature of a mammalian body part has at least two landmarksubsurface features and at least two regions of interest. Each landmarksubsurface feature of at least two landmark subsurface features has arespective spatial relationship to a respective region of interest ofthe at least two regions of interest. For example, the referenceoperation may be implemented using the coordinate analysis circuit 1524described in conjunction with FIG. 35. A registration operation 1620includes registering the respective regions of interest of a mammalianbody part. The registration is at least partially based on the commonframe of reference. For example, the registration operation may beimplemented at least in part using the registration circuit 1526described in conjunction with FIG. 35. A storage operation 1630 includesmaintaining in a computer-readable media informational datacorresponding to the respective registered regions of interest. Forexample, the storage operation may be implemented at least in part usingthe computer-readable media 235 described in conjunction with FIG. 3.

FIG. 37 illustrates an alternative embodiment of the operational flow1600 of FIG. 36. In an embodiment, the reference operation 1610 mayinclude at least one additional embodiment. The at least one additionalembodiment may include an operation 1611 or an operation 1612. Theoperation 1611 includes determining a common frame of reference that isat least partially based on a landmark subsurface feature of a cavity orlumen of a mammalian body part. The cavity or lumen of the mammalianbody part has at least two landmark subsurface features and at least tworegions of interest. Each landmark subsurface feature of at least twolandmark subsurface features has a respective spatial relationship to arespective region of interest of the at least two regions of interest.The operation 1612 includes determining a common frame of reference thatis at least partially based on a landmark subsurface feature of a cavityor lumen of a mammalian body part. The cavity or lumen of the mammalianbody part has at least two landmark subsurface features and at least tworegions of interest of a surface of the cavity or lumen. Each landmarksubsurface feature of at least two landmark subsurface features has arespective spatial relationship to a respective region of interest ofthe at least two regions of interest.

In an embodiment, the registration operation 1620 may include at leastone additional embodiment, such as the operation 1621. The operation1621 includes registering the respective regions of interest of amammalian body part. The registration is at least partially based on thedetermined common frame of reference and on a spatial relationship amongeach landmark subsurface feature of at least two landmark subsurfacefeatures.

In an embodiment, the storage operation 1630 may include at least oneadditional embodiment, such as the operation 1631. The operation 1631includes maintaining in a computer-readable media informational datacorresponding to the respective registered regions of interest, andproviding electronic access to the informational data.

FIG. 38 illustrates an alternative embodiment of the operational flow1610 of FIG. 36. The operational flow may include at least on additionaloperation 1640. The at least one additional operation may include anoperation 1641, an operation 1642, an operation 1643, or an operation1644. The operation 1641 includes transforming the informational datainto a particular visual depiction of the respective registered regionsof interest. The operation 1642 includes transforming the informationaldata into a particular visual depiction of a spatial relationship amongthe respective registered regions of interest. The operation 1643includes outputting the informational data. The operation 1644 includesproviding a notification that is at least partially based on theinformational data to at least one of a human, computer, or system. Inan embodiment, the operational flow may include receiving at least twomedical images (not illustrated). Each medical image of the received atleast two medical images includes a respective region of interest of themammalian body part.

FIG. 39 illustrates an example computer program product 1700. Thecomputer program product includes a computer-readable media 1710 bearingprogram instructions 1720. The program instructions, when executed by aprocessor of a computing device, cause the computing device to perform aprocess. The process includes determining a common frame of reference atleast partially based on a landmark subsurface feature of a mammalianbody part having at least two landmark subsurface features and at leasttwo regions of interest. Each landmark subsurface feature of at leasttwo landmark subsurface features has a respective spatial relationshipto a respective region of interest of the at least two regions ofinterest. The process includes registering the respective regions ofinterest of a mammalian body part. The registration is at leastpartially based on the common frame of reference. The process includesstoring in another computer-readable media operably coupled with theprocessor informational data corresponding to the respective registeredregions of interest.

In an embodiment, the process further includes 1732 transforming theinformational data into a signal useable in providing a particularvisual depiction of the respective registered regions of interest. In anembodiment, the process further includes 1734 providing a notificationto at least one of humans, computers, or systems indicative of therespective registered regions of interest.

In an embodiment, the computer-readable media 1710 includes a tangiblecomputer-readable media 1712. In an embodiment, the computer-readablemedia includes a communications media 1714.

FIG. 40 illustrates an example system 1800. The system includes means1810 for determining a common frame of reference that is at leastpartially based on a landmark subsurface feature of a mammalian bodypart. The mammalian body part has at least two landmark subsurfacefeatures and at least two regions of interest. Each landmark subsurfacefeature of at least two landmark subsurface features has a respectivespatial relationship to a respective region of interest of the at leasttwo regions of interest. The system includes means 1820 for registeringthe respective regions of interest of a mammalian body part. Theregistration is at least partially based on the common frame ofreference. The system includes means 1830 for persistently maintainingcomputer-readable informational data corresponding to the respectiveregistered regions of interest.

In an embodiment, the system 1800 may include means 1840 fortransforming the informational data into a particular visual depictionof the respective registered regions of interest. In an embodiment, thesystem may include means 1850 for outputting the informational data. Inan embodiment, the system may include means 1860 for providing anotification that is at least partially based on the informational datato at least one of a human, computer, or system.

FIG. 41 illustrates an example environment 1900. The environmentincludes the mammalian body part 210 of the mammal 205, and a system1920. The system includes a receiver circuit 1922 configured to receiveat least two medical images. Each medical image of the at least twomedical images includes a respective region of interest of a mammalianbody part. The receiver circuit is also configured to receive at leasttwo reference images. Each reference image of the at least two referenceimages includes a respective landmark subsurface feature of themammalian body part. Each landmark subsurface feature has a respectivespatial relationship to a respective region of interest included in amedical image of the at least two medical images. For example, FIG. 4illustrates regions of interest 214A and 214B of the mammalian body part210. These regions of interest may be respectively included in twomedical images, one medical image for each region of interest.

FIG. 42 illustrates three example reference images 1992A-1992C that haverespective fields of view 1994A-1994C. These fields of view respectivelyinclude the landmark subsurface features 216A-216C. The respectivelandmark subsurface features 216A-216C are also illustrated in FIG. 4.Landmark subsurface features 216A and 216B have respective spatialrelationships 217A and 217B respectively to the regions of interest 214Aand 214B. In addition, landmark subsurface feature 216C has the spatialrelationship 213B to landmark subsurface feature 216B.

Continuing with FIG. 41, the system 1920 includes a coordinate analysiscircuit 1924 configured to determine a common frame of reference that isat least partially based on a landmark subsurface feature included in areference image of the at least two reference images. The systemincludes a registration circuit 1926 configured to register therespective regions of interest included in the at least two medicalimages. The registration is at least partially based on the determinedcommon frame of reference. The system includes the computer-readablemedia 235 configured to maintain informational data corresponding to therespective registered regions of interest included in the at least twomedical images.

In an embodiment, a first landmark subsurface feature of the mammalianbody part of a first digital image of at least two digital images and asecond landmark subsurface feature of the mammalian body part of asecond reference image of the at least two reference images are the samelandmark subsurface feature. For example, FIG. 42 illustrates thelandmark subsurface feature 216C of the reference image 1992C as beingthe same landmark subsurface feature as the landmark subsurface feature216C of the reference image 1992A. Please note that in an embodiment,while the field of view 1994A of the reference image 1992A includes thetwo landmark subsurface features 216A and 216C, neither landmarksubsurface feature 216A or 216B of landmark subsurface feature 216A isnecessarily a “second landmark subsurface feature.” In an embodiment,first landmark subsurface feature of the mammalian body part of a firstreference image of the at least two reference images and a secondlandmark subsurface feature of the mammalian body part of a secondreference image of the at least two reference images are differentlandmark subsurface features. For example, FIG. 42 illustrates thelandmark subsurface feature 216C of reference image 1992C as being adifferent landmark subsurface feature than the landmark subsurfacefeature 216B of the reference image 1992B.

Continuing with FIG. 41, in an embodiment, the least two medical imagesmay have been acquired by a body-insertable device, such as the bodyinsertable device 280, while a portion of the body-insertable device waspresent in a cavity or lumen of a mammalian body part 210. Each medicalimage of the at least two medical images include a respective region ofinterest of the mammalian body part. In an embodiment, thebody-insertable device may be configured for examination or inspectionof a cavity or lumen of a mammalian body part. In an embodiment, eachmedical image of the at least two medical images may include arespective region of interest of a cavity or lumen of a mammalian bodypart. Referring to FIG. 4 for example, a first medical image may includethe region of interest 214A, a second medical image may include theregion of interest 214B, and a third medical image may include theregion of interest 214C, all of the cavity or lumen 212 of the mammalianbody part 210. In an embodiment, each medical image of the at least twomedical images may include a respective region of interest of a surfaceof a cavity or lumen of a mammalian body part. Referring to FIG. 4 forexample, a first medical image may include the region of interest 214A,a second medical image may include the region of interest 214B, and athird medical image may include the region of interest 214C of thesurface 212, all of the cavity or lumen 211 of the mammalian body part210.

Continuing with FIG. 41, in an embodiment, the at least two medicalimages may have been acquired by an ex vivo device, such as the device290. Each medical image of the at least two medical images includes arespective region of interest of the mammalian body part. In anembodiment, the at least two reference images may have been acquired byan ex vivo device. Each reference image of the at least two referenceimages includes a respective landmark subsurface feature of themammalian body part. Each landmark subsurface feature has a respectivespatial relationship to a respective region of interest included in amedical image of the at least two medical images. For example, eachreference image of the at least two reference images is representativeof a respective landmark subsurface feature of the mammalian body part.Each landmark subsurface feature has a spatial relationship to arespective region of interest included in a medical image of the atleast two medical images. For example, each reference image of the atleast two reference images may include a respective landmark subsurfacefeature of the cavity or lumen of the mammalian body part. Each landmarksubsurface feature has a spatial relationship to a respective region ofinterest of the cavity or lumen of the mammalian body part is includedin a medical image of the at least two medical images. For example, eachreference image of the at least two reference images may include arespective landmark subsurface feature of the mammalian body part. Eachlandmark subsurface feature has a spatial relationship to a respectiveregion of interest of the mammalian body part included in a medicalimage of the at least two medical images. A first reference imageincludes a first landmark subsurface feature of the mammalian body parthaving a first spatial relationship to the first region of interest. Asecond reference image includes a second landmark subsurface featurehaving a second spatial relationship to a second region of interest. Thesecond landmark subsurface feature also includes a third spatialrelationship to the first subsurface feature. For example, FIG. 4illustrates the landmark subsurface feature 216B having a spatialrelation 217B to the region of interest 214B, and having a spatialrelationship 213D to the region of interest 214A.

Continuing with FIG. 41, in an embodiment, the coordinate analysiscircuit 1924 may be configured to determine a common frame of referenceand a coordinate reference system. The determination is at leastpartially based on a landmark subsurface feature included in a referenceimage of the at least two reference images. In an embodiment, thecoordinate analysis circuit may be configured to determine a commonframe of reference anchored in a landmark subsurface feature that isincluded in a reference image of the at least two reference images. Inan embodiment, the coordinate analysis circuit may be configured todetermine a coordinate reference system at least partially based on alandmark subsurface feature included in a reference image of the atleast two reference images.

In an embodiment, the registration circuit 1926 may be configured toregister the respective regions of interest included in the at least twomedical images. The registration is at least partially based on thedetermined common frame of reference and on a spatial relationship amongeach respective landmark subsurface feature of the at least tworeference images. In an embodiment, the registration circuit may beconfigured to register a spatial relationship of the respective regionsof interest included in the at least two medical images. Theregistration is at least partially based on the determined common frameof reference. In an embodiment, the registration circuit may beconfigured to register the respective regions of interest included inthe at least two medical images. The registration is at least partiallybased on the determined common frame of reference and includes anorientation of the respective regions of interest.

In an embodiment, the computer-readable media 235 may be configured tomaintain and to provide electronic access to informational datacorresponding to the registration of the respective regions of interestincluded in the at least two medical images. In an embodiment, thecomputer-readable media may be configured to maintain informational datacorresponding to the respective registered regions of interest includedin the at least two medical images, and to maintain informational datacorresponding to the determined common frame of reference. In anembodiment, a computer storage device includes the computer-readablemedia, which may be configured to maintain informational datacorresponding to the respective registered regions of interest includedin the at least two medical images.

In an embodiment, the system 1920 may include a communication circuit,such as for example the communication circuit 1942, configured to outputthe informational data. In an embodiment, the system may be configuredto provide a notification that is at least partially based on theinformational data to at least one of a human, computer, or system.

FIG. 43 illustrates an example operational flow 2000. The operationalflow includes a start operation. A first reception operation 2010includes receiving at least two medical images. Each medical image ofthe at least two medical images includes a respective region of interestof a mammalian body part. For example, the first reception operation maybe implemented using the receiver circuit 1922 described in conjunctionwith FIG. 41. A second reception operation 2020 includes receiving atleast two reference images. Each reference image of the at least tworeference images includes a respective landmark subsurface feature ofthe mammalian body part. Each landmark subsurface feature has arespective spatial relationship to a respective region of interestincluded in a medical image of the at least two medical images. Forexample, the second reception operation may be implemented using thereceiver circuit 1922 described in conjunction with FIG. 41. A referenceoperation 2030 includes determining a common frame of reference. Thedetermination is at least partially based on a landmark subsurfacefeature included in a reference image of the at least two referenceimages. For example, the reference operation may be implemented usingthe coordinate analysis circuit 1924 described in conjunction with FIG.41. A registration operation 2040 includes registering the respectiveregions of interest included in the at least two medical images. Theregistration is at least partially based on the common frame ofreference. For example, the registration operation may be implementedusing the registration circuit 1926 described in conjunction with FIG.41. A storage operation 2050 includes maintaining in a computer-readablemedia informational data corresponding to the registration of therespective regions of interest included in the at least two medicalimages. For example, the storage operation may be implemented using thecomputer-readable media 235 described in conjunction with FIG. 3. Theoperational flow includes an end operation.

FIG. 44 illustrates an alternative embodiment of the operational flow2000 described in FIG. 43. The reference operation 2030 may include atleast one additional operation, such as the operation 2032. Theoperation 2032 includes determining a common frame of reference anddetermining a spatial relationship among each respective landmarksubsurface feature of the at least two reference images. The determininga common frame of reference and determining a spatial relationship areat least partially based on a landmark subsurface feature included in areference image of the at least two reference images. The registrationoperation 2040 may include at least one additional embodiment, such asthe operation 2042. The operation 2042 includes registering therespective regions of interest included in the at least two medicalimages. The registration is at least partially based on the common frameof reference and on a spatial relationship among each respectivelandmark subsurface feature of the at least two reference images. In anembodiment, the storage operation 2050 may include at least oneadditional embodiment, such as the operation 2052. The operation 2052includes maintaining in a computer-readable media informational datacorresponding to the registration of the respective regions of interest.The operation 2052 also includes providing electronic access to theinformational data.

FIG. 45 illustrates an alternative embodiment of the operational flow2000 described in FIG. 43. The operational flow may include at least oneadditional embodiment, illustrated as additional operation 2060. Theadditional operation may include an operation 2061, an operation 2062,an operation 2063, an operation 2064, an operation 2065, or an operation2066. The operation 2061 includes extracting the respective landmarksubsurface features of the mammalian body part from the at least tworeference images. The operation 2062 includes outputting data usable indisplaying a human-perceivable indication of the informational data. Theoperation 2063 includes transforming the informational data into aparticular visual depiction of the registration of the respectiveregions of interest included in the at least two medical images. Theoperation 2064 includes transforming the informational data into aparticular visual depiction of the relative spatial relationships of therespective regions of interest included in the at least two medicalimages. The operation 2065 includes outputting the informational data.The operation 2066 includes providing a notification that is at leastpartially based on the informational data to at least one of a human,computer, or system.

FIG. 46 illustrates a computer program product 2100. The computerprogram product includes a computer-readable media 2110 bearing programinstructions 2120. The program instructions, when executed by aprocessor of a computing device, cause the computing device to perform aprocess. The process includes receiving at least two medical images.Each medical image of the at least two medical images includes arespective region of interest of a mammalian body part. The processincludes receiving at least two reference images. Each reference imageof the at least two reference images includes a respective landmarksubsurface feature of the mammalian body part. Each landmark subsurfacefeature has a respective spatial relationship to a respective region ofinterest included in a medical image of the at least two medical images.The process includes determining a common frame of reference. The commonframe of reference is determined that is at least partially based on alandmark subsurface feature included in a reference image of the atleast two reference images. The process includes registering therespective regions of interest included in the at least two medicalimages. The registration is at least partially based on the common frameof reference. The process includes storing in another computer-readablemedia operably coupled with the processor informational datacorresponding to the registration of the respective regions of interestincluded in the at least two medical images.

In an embodiment, the determining may include 2121 determining a commonframe of reference and determining a spatial relationship among eachrespective landmark subsurface feature of the at least two referenceimages. The determining a common frame of reference and determining aspatial relationship are at least partially based on a landmarksubsurface feature included in a reference image of the at least tworeference images. In an embodiment, the registering may include 2122registering the respective regions of interest included in the at leasttwo medical images. The registration is at least partially based on thedetermined common frame of reference and on a spatial relationship amongeach respective landmark subsurface feature of the at least tworeference images. In an embodiment, the computer-readable media 2110 mayinclude a tangible computer-readable media 2112. In an embodiment, thecomputer-readable media may include a communications media 2114.

FIG. 47 illustrates an alternative embodiment of the computer programproduct 2100 of FIG. 46. In an embodiment, the storing may include 2123storing in another computer-readable media operably coupled with theprocessor informational data corresponding to the registration of therespective regions of interest, and providing electronic access to theinformational data. In an embodiment, the process 2120 may include 2132extracting the respective landmark subsurface features of the mammalianbody part from the at least two reference images. In an embodiment, theprocess may include 2134 outputting the informational data. In anembodiment, the process may include 2136 outputting data usable indisplaying a human-perceivable indication of the informational datacorresponding to the registration of the respective regions of interestincluded in the at least two medical images. In an embodiment, theprocess may include 2138 transforming the registration of the respectiveregions of interest into a particular visual depiction of theregistration of the respective regions of interest. In an embodiment,the process may include transforming the registration of the respectiveregions of interest into a particular visual depiction of the relativespatial relationships of the respective regions of interest [notillustrated]. In an embodiment, the process may include 2139 providing anotification that is at least partially based on the informational datato at least one of a human, computer, or system.

FIG. 48 illustrates an example system 2200. The system includes means2210 for receiving at least two medical images. Each medical image ofthe at least two medical images includes a respective region of interestof a mammalian body part. The system includes means 2220 for receivingat least two reference images. Each reference image of the at least tworeference images includes a respective landmark subsurface feature ofthe mammalian body part. Each landmark subsurface feature has arespective spatial relationship to a respective region of interestincluded in a medical image of the at least two medical images. Thesystem includes means 2230 for determining a common frame of referencethat is at least partially based on a landmark subsurface featureincluded in a reference image of the at least two reference images. Thesystem includes means 2240 for registering the respective regions ofinterest included in the at least two medical images. The registrationis at least partially based on the determined common frame of reference.The system includes means 2250 for persistently maintainingcomputer-readable informational data corresponding to the respectiveregistered regions of interest included in the at least two medicalimages.

FIG. 49 illustrates an example environment 2300. The environmentincludes the mammalian body part 210 of the mammal 205, and a system2320. The system includes an image coregistration circuit 2328. Theimage coregistration circuit is configured to coregister a firstdepiction by a reference medical image of a region of interest of amammalian body part and a second depiction by a target medical image ofthe region of interest of the mammalian body part. The first depictionof the region of interest has a first spatial relationship to a landmarksubsurface feature of the mammalian body part during a first condition.The second depiction of the region of interest has a second spatialrelationship to the landmark subsurface feature of the mammalian bodypart during a second condition. The coregistration of the firstdepiction of the region of interest and the second depiction of theregion of interest is at least partially based on the first spatialrelationship and on the second spatial relationship. For example, FIG.50 illustrates an embodiment with a reference image having a field ofview 2295 of the lumen or cavity 212 of the mammalian body part 210. Thefield of view 2295 includes the landmark subsurface feature 216A havinga first spatial relationship 2996 to a first depiction of the region ofinterest 214A. FIG. 50 also illustrates an embodiment with a targetdigital image having a field of view 2297 of the lumen or cavity of themammalian body part. The field of view 2297 includes the landmarksubsurface feature 216A having a second spatial relationship 2298 to asecond depiction of the region of interest 214A.

In an embodiment, “coregister” or “coregistration” of depictions of aregion of interest or of images depicting a region of interest includestransforming corresponding different sets of data each representing thedepiction of the region of interest into one coordinate system. Onceco-registered, the different depictions of the region of interest or ofimages depicting the region of interest can be compared or integrated.In an embodiment, “coregister” or “coregistration” of differentdepictions of the region of interest or of images depicting the regionof interest includes bringing the different depictions into analignment. In an embodiment, “coregister” or “coregistration” ofdifferent depictions includes aligning depictions by two differentmodalities, such as a PET image and an MRI image. In an embodiment,“coregister” or “coregistration” of different depictions includesoverlaying the depictions with a correct orientation and geometry sothat corresponding internal features align.

In an embodiment, “coregister” or “coregistration” of imagesrepresenting a scene or object, such as a region of interest or alandmark subsurface feature, includes transforming correspondingdifferent sets of data each representing the scene or object into onecoordinate system. Once co-registered, the different images can becompared or integrated. In an embodiment, “coregister” or“coregistration” of different images representing a scene or objectincludes bringing the different images into an alignment. In anembodiment, “coregister” or “coregistration” of different imagesrepresenting a scene or object includes aligning images of two differentmodalities, such as a PET image and an MRI image. In an embodiment,“coregister” or “coregistration” of different images representing ascene or object includes overlaying the images with a correctorientation and geometry so that corresponding internal features align.

Returning to FIG. 49, the system also includes the computer-readablemedia 235. The computer-readable media configured to maintaininformational data corresponding to the coregistration of the firstdepiction of the region of interest and the second depiction of theregion of interest.

In an embodiment, the first condition may include a first surgical stateand the second condition includes a second surgical state. For example,the first surgical state may include a pre-surgical state of a surfaceof a colon and the second surgical state may include post surgical stateof the surface of the colon. In an embodiment, the first condition mayinclude a first disease state of the mammalian body part and the secondcondition includes a second disease state of the mammalian body part.For example, a progression of a lesion on a surface of a colon over timemay be illustrated by the first condition and the second condition. Inan embodiment, the first condition includes a first time and the secondcondition includes a second time, wherein the first time and the secondtime are close in time. For example, the first condition and the secondcondition may be relative to seconds, minutes or a few hours of eachother. For example, as during a single endoscopic examination procedureof a colon. For example, a first disease state may be a state of noapparent pathology, and a second disease state may be a state of anapparent pathology. For example, a first disease state may be a firststage of an apparent pathology, and a second disease state may be asecond state of the apparent pathology. For example, a first diseasestate may be a disease state of the region interest beforeadministration of a therapeutic substance to mammal and a second diseasestate may be a disease state of the region of interest afteradministration of the therapeutic substance to mammal. This would allowa heath care provider to monitor the effect of the administration of thetherapeutic substance to mammal, and possible form a basis for futuretreatment of the mammal using the coregistered first depiction of theregion of interest and the second depiction of the region of interest.In an embodiment, the first condition includes first time and the secondcondition includes second time, wherein the first time and the secondtime are substantially different times. For example, such as more than12 hours from each other. For example, as during different endoscopicexamination procedures of a colon occurring several weeks, months, oryears apart.

In an embodiment, the second spatial relationship is substantially thesame as the first spatial relationship. For example, when there has notbeen movement within the body part. In an embodiment, the second spatialrelationship is substantially different from the first spatialrelationship. For example, where there has been movement within the bodypart, such as the patient breathed or shifted position, or some temporalchange.

In an embodiment, the image coregistration circuit 2328 includes animage coregistration circuit configured to coregister a first depictionby a reference medical image of a region of interest of a cavity orlumen of a mammalian body part during a first condition and a seconddepiction by a target medical image of the region of interest of thecavity or lumen of the mammalian body part during a second condition.The region of interest has a first spatial relationship to a landmarksubsurface feature of the cavity or lumen of the mammalian body partduring the first condition. The region of interest has a second spatialrelationship to the landmark subsurface feature of the cavity or lumenof the mammalian body part during the second condition. Thecoregistration of the first depiction of the region of interest and thesecond depiction of the region of interest is at least partially basedon the first spatial relationship and on the second spatialrelationship. In an embodiment, the image coregistration circuitincludes an image coregistration circuit configured to coregister afirst depiction by a reference medical image of a region of interest ofa surface of a cavity or lumen of a mammalian body part, during thefirst condition the region of interest has a first spatial relationshipto a landmark subsurface feature of the cavity or lumen of the mammalianbody part during a first condition, and a second depiction by a targetmedical image of the region of interest of the surface of the cavity orlumen of the mammalian body part during a second condition, the regionof interest has a second spatial relationship to the landmark subsurfacefeature of the cavity or lumen of the mammalian body part during thesecond condition. The coregistration of the first depiction of theregion of interest and the second depiction of the region of interest isat least partially based on the first spatial relationship and on thesecond spatial relationship.

In an embodiment, the image coregistration circuit 2328 includes animage coregistration circuit configured to coregister relative locationsof a first depiction by a reference medical image of a region ofinterest of a mammalian body part during a first condition, the regionof interest has a first spatial relationship to a landmark subsurfacefeature of the mammalian body part during the first condition, and asecond depiction by a target medical image of the region of interest ofthe mammalian body part during a second condition, the region ofinterest has a second spatial relationship to the landmark subsurfacefeature of the mammalian body part during the second condition. Thecoregistration of the first depiction of the region of interest and thesecond depiction of the region of interest is at least partially basedon the first spatial relationship and on the second spatialrelationship. In an embodiment, the image coregistration circuitincludes an image coregistration circuit configured to coregisterrelative locations and orientations of a first depiction by a referencemedical image of a region of interest of a mammalian body part during afirst condition, the region of interest has a first spatial relationshipto a landmark subsurface feature of the mammalian body part during thefirst condition, and a second depiction by a target medical image of theregion of interest of the mammalian body part during a second condition,the region of interest has a second spatial relationship to the landmarksubsurface feature of the mammalian body part during the secondcondition. The coregistration of the first depiction of the region ofinterest and the second depiction of the region of interest is at leastpartially based on the first spatial relationship and on the secondspatial relationship.

In an embodiment, the computer-readable media 235 includes acomputer-readable media configured to maintain and provide access toinformational data corresponding to the coregistration of the firstdepiction of the region of interest and the second depiction of theregion of interest.

In an embodiment, the system 2320 includes a communication circuit 2342configured to output a signal usable in displaying a human-perceivableindication of the coregistration of the first depiction of the region ofinterest and the second depiction of the region of interest. In anembodiment, the system 2320 may include a receiver circuit 2322configured to receive the first depiction and the second depiction. Inan embodiment, the system may include the registration circuit 2326. Inan embodiment, the system may include the processor 232. In anembodiment, the system may include the computer storage device 234. Inan embodiment, the system may include the extraction engine 238.

In an embodiment, the system 2320 includes a comparative-analysiscircuit (not shown) configured to detect a change in the region ofinterest of the mammalian body part at least partially based on thecoregistered first depiction of the region of interest and seconddepiction of the region. For example, the comparative-analysis circuit(not shown) may be configured to detect a change in the region ofinterest of the mammalian body part using a pattern recognitionmethodology, or an artificial intelligence methodology. For example, thedetected change may include a change in one or more blood vessels in theregion of interest, such as number of blood vessels, size of one or moreblood vessels, or a pattern formed by blood vessels. In an example, adetected change may include a new pattern of blood vessels, which mayindicate a tumor disease state in the region of interest. Such“neo-angiogenesis” can be apparent even at the microscopic level quiteearly on. In another example, a detected change in a presence ofcapillary buds or other angiogenesis may indicate inflammation in theregion of interest. In a further example, a detected change may includea detected change in a size, color, or border of a lesion in the regionof interest. In an example, a detected change may include a change in apattern of surface topology, which could indicate tumor, polyps,inflammatory bowel disease, ulcerations, or the like. In an embodiment,the comparative-analysis circuit may be configured to compare thecoregistered first depiction of the region of interest and seconddepiction of the region of interest and detect a change in the region ofinterest over time. This is expected to be of assistance to health careproviders in diagnosis and treatment of disease.

For example, in use, a change in the region of interest detected by thecomparative-analysis circuit may include a change in GI tract (stomach,intestine, colon, rectum, etc.), in lungs, or in blood vessels. Thefirst depiction of the region of interest and the second depiction ofthe region of interest may be acquired during endoscopic examination the(using capsule endoscopy and traditional colonoscopy) of the body part.The first depiction of the region of interest and the second depictionof the region of interest may be used in comparing images of the sameregion at two different times to look for a change in disease state orcondition and report change, or may be used reporting a “questionablesite” that should be looked at in further detail or providinginformation on the actual change. For example, in use, a change in theregion of interest detected by the comparative-analysis circuit mayinclude a change between in an image taken of a region or interest atone time, e.g. in a state/condition of no apparent disease, then animage taken of a region or interest taken at a second time, e.g. in afollow-up colonoscopy, comparing a second image of the region anddetermining the change in state/condition with no prior knowledge of thestate/condition. The comparison could include a change in a pattern.Information from comparisons can be added to provide more specificityand sensitivity. For example, if there is a change in blood vessels, theinformation may include a look at topology, or add results of thecomparison to a list or report. Another example would be the absence ofa disease state, e.g. after treatment with a therapeutic, especially ananti-angiogenic, the tumor or aberrant vascularization will be lessenedand even absent. One example would be that a detected new pattern ofblood vessels could indicate the onset of a tumor disease state. Such“neo-angiogenesis” may be apparent even at the microscopic level quiteearly on. Similarly, a detected presence of capillary buds or otherangiogenesis may indicate onset of inflammation. Detected changes inpatterns of surface topology may indicate tumor, polyps, inflammatorybowel disease, ulcerations. For example, in use, a detected change inthe region of interest by the comparative-analysis circuit may be usedfor example in people at risk for certain diseases, in patients tofollow progression of a disease state, in patients to assess therapeuticresponse, post-surgery or other intervention to monitor for relapse. Forexample, a change in the region of interest detected by thecomparative-analysis circuit may include a change in a pattern in aportion of a larger field, where the larger field is used to align theimager.

Further, the system 2320 may include a decision circuit (not shown)operable to recommend or initiate acquisition of additional depictionsof the region of interest, acquisition of a higher resolution depictionof the region of interest, acquisition of a depiction of the region ofinterest at a different wavelength or modality, or acquisition of anenhanced depiction of the region of interest, such with a contrastagent.

FIG. 51 illustrates an example operational flow 2400. The operationalflow includes a start operation. The operational flow includes acoregistration operation 2410. The coregistration operation includescoregistering a first depiction by a reference medical image of a regionof interest of a mammalian body part during a first condition and asecond depiction by a target medical image of the region of interest ofthe mammalian body part during a second condition. The region ofinterest has a first spatial relationship to a landmark subsurfacefeature of the mammalian body part during the first condition. Theregion of interest has a second spatial relationship to the landmarksubsurface feature of the mammalian body part during the secondcondition. The coregistration of the first depiction of the region ofinterest and the second depiction of the region of interest is at leastpartially based on the first spatial relationship and on the secondspatial relationship. In an embodiment, the coregistration operation maybe implemented using the image coregistration circuit 2328 of FIG. 49.The operational flow includes a storage operation 2420. The storageoperation includes maintaining in a computer-readable mediainformational data corresponding to the coregistration of the firstdepiction of the region of interest and the second depiction of theregion of interest. In an embodiment, the storage operation may beimplemented using the computer-readable media 235 described inconjunction with FIG. 49. The operational flow includes an endoperation.

FIG. 52 illustrates an alternative embodiment of the operational flow2400 of FIG. 51. The operational flow may include at least oneadditional embodiment, such as an operation 2430. The operation 2430includes receiving the first depiction by a reference medical image ofthe region of interest of the mammalian body part, and receiving thesecond depiction by a target medical image of the region of interest ofthe mammalian body part. In an embodiment, the storage operation 2420may include at least one additional embodiment, such as the operation2421. The at least one additional embodiment includes maintaining in acomputer-readable media informational data corresponding to thecoregistration of the first depiction of the region of interest and thesecond depiction of the region of interest, and providing electronicaccess to the informational data.

FIG. 53 illustrates an alternative embodiment of the operational flow2400 of FIG. 51. The operational flow may include at least oneadditional embodiment illustrated as operation 2440. The operation 2400includes an operation 2441, an operation 2442, an operation 2443, anoperation 2444, or an operation 2445. The operation 2441 includesoutputting a signal usable in displaying a human-perceivable indicationof the informational data. The operation 2442 includes transforming theinformational data into a particular visual representation of thecoregistration of the first depiction of the region of interest and thesecond depiction of the region of interest. The operation 2443 includestransforming the informational data into a particular visualrepresentation of the relative spatial relationships of the firstdepiction of the region of interest and the second depiction of theregion of interest. The operation 2444 includes outputting theinformational data. The operation 2445 includes providing a notificationthat is at least partially based on the informational data to at leastone of a human, computer, or system.

FIG. 54 illustrates a computer program product 2500. The computerprogram product includes a computer-readable media 2510 bearing programinstructions 2520. The program instructions, when executed by aprocessor of a computing device, cause the computing device to perform aprocess. The process includes coregistering a first depiction by areference medical image of a region of interest of a mammalian body partduring a first condition and a second depiction by a target medicalimage of the region of interest of the mammalian body part during asecond condition. The region of interest has a first spatialrelationship to a landmark subsurface feature of the mammalian body partduring the first condition. The region of interest has a second spatialrelationship to the landmark subsurface feature of the mammalian bodypart during the second condition. The coregistering of the firstdepiction and the second depiction is at least partially based on thefirst spatial relationship and on the second spatial relationship. Theprocess includes storing in another computer-readable media operablycoupled with the processor informational data corresponding to thecoregistration of the first depiction of the region of interest and thesecond depiction of the region of interest.

In an embodiment, the computer-readable media 2510 includes a tangiblecomputer-readable media 2512. In an embodiment, the computer-readablemedia includes a communications media 2514.

In an embodiment, the storing process includes 2522 storing in anothercomputer-readable medium operably coupled with the processorinformational data corresponding to the coregistration of the firstdepiction of the region of interest and the second depiction of theregion of interest, and providing electronic access to the informationaldata.

FIG. 55 illustrates an alternative embodiment of the programinstructions 2520 which cause the computing device to perform a process.In an embodiment, the process further includes 2531 outputting theinformational data. In an embodiment, the process further includes 2532outputting a signal usable in displaying a human-perceivable indicationof the coregistration of the first depiction of the region of interestand the second depiction of the region of interest. In an embodiment,the process further includes 2533 transforming the informational datainto a particular visual depiction of the coregistration of the firstdepiction of the region of interest and the second depiction of theregion of interest. In an embodiment, the process further includes 2534providing a notification that is at least partially based on theinformational data to at least one of a human, computer, or system.

FIG. 56 illustrates an example system 2600. The system includes means2610 for coregistering a first depiction by a reference medical image ofa region of interest of a mammalian body part during a first condition,the region of interest has a first spatial relationship to a landmarksubsurface feature of the mammalian body part during the firstcondition, and a second depiction by a target medical image of theregion of interest of the mammalian body part during a second condition,the region of interest has a second spatial relationship to the landmarksubsurface feature of the mammalian body part during the secondcondition. The coregistration of the first depiction of the region ofinterest and the second depiction of the region of interest is at leastpartially based on the first spatial relationship and on the secondspatial relationship. The system includes means 2620 for persistentlymaintaining computer-readable informational data corresponding to thecoregistration of the first depiction of the region of interest and thesecond depiction of the region of interest. In an embodiment, the systemincludes means for receiving the reference medical image; means forreceiving the target medical image; means for receiving the first dataindicative of a first spatial relationship; and means for receiving thesecond data indicative of a second spatial relationship. [notillustrated]

Returning to FIG. 49, which illustrates an alternative embodiment of thesystem 2320. The alternative embodiment of the system 2320 includes thereceiver circuit 2322 configured to receive (i) a reference image thatincludes a first depiction of a region of interest of a mammalian bodypart during a first condition, and (ii) a target digital image thatincludes a second depiction the region of interest of the mammalian bodypart during a second condition. The receiver circuit is also configuredto receive (iii) a first data indicative of a first spatial relationshipbetween a landmark subsurface feature of the mammalian body part and theregion of interest during the first condition, and (iv) a second dataindicative of a second spatial relationship between the landmarksubsurface feature of the mammalian body part and the region of interestduring the second condition. In an embodiment, the first digital imageincludes the first data indicative of a first spatial relationshipbetween a landmark subsurface feature of the mammalian body part and theregion of interest during the first condition. For example, the firstdigital image may include the reference image. For example, the firstdigital image may be an image other than the reference image. In anembodiment, the second first digital image includes the second dataindicative of a first spatial relationship between a landmark subsurfacefeature of the mammalian body part and the region of interest during thefirst condition. For example, the second digital image may include thetarget image. For example, the second digital image may be an imageother than the target image.

The image coregistration circuit 2328 is configured to coregister thefirst depiction of the region of interest and the second depiction ofthe region of interest. The coregistration is at least partially basedon the first spatial relationship and on the second spatialrelationship. The computer-readable media 235 is configured to maintaininformational data corresponding to the coregistration of the firstdepiction of the region of interest and the second depiction of theregion of interest.

In an embodiment of the alternative embodiment, the receiver circuit2322 is configured to receive (i) a reference medical image thatincludes a first depiction of a region of interest of a cavity or lumenof a mammalian body part during a first condition, (ii) a target medicalimage that includes a second depiction the region of interest of thecavity or lumen of the mammalian body part during a second condition.The receiver circuit is also configured to receive (iii) a first dataindicative of a first spatial relationship between a landmark subsurfacefeature of the cavity or lumen of the mammalian body part and the regionof interest during the first condition, and (iv) a second dataindicative of a second spatial relationship between the landmarksubsurface feature of the cavity or lumen of the mammalian body part andthe region of interest during the second condition. In an embodiment,the receiver circuit is configured to receive (i) a reference medicalimage that includes a first depiction of a region of interest of asurface of a cavity or lumen of a mammalian body part during a firstcondition, (ii) a target medical image that includes a second depictionthe region of interest of the surface of the cavity or lumen of themammalian body part during a second condition. The receiver circuit isalso configured to receive (iii) a first data indicative of a firstspatial relationship between a landmark subsurface feature of thesurface of the cavity or lumen of the mammalian body part and the regionof interest during the first condition, and (iv) a second dataindicative of a second spatial relationship between the landmarksubsurface feature of the surface of the cavity or lumen of themammalian body part and the region of interest during the secondcondition.

In an embodiment of the alternative embodiment, the receiver circuit2322 is configured to receive (i) a reference medical image that wasacquired by a first device and includes a first depiction of a region ofinterest of a mammalian body part during a first condition, and (ii) atarget medical image that was acquired by a second device and includes asecond depiction the region of interest of the mammalian body partduring a second condition. The receiver circuit is also configured toreceive (iii) a first data was acquired by a third device and indicativeof a first spatial relationship between a landmark subsurface feature ofthe mammalian body part and the region of interest during the firstcondition, and (iv) a second data acquired by a fourth device andindicative of a second spatial relationship between the landmarksubsurface feature of the mammalian body part and the region of interestduring the second condition. In an embodiment, the first device includesa body-insertable device. In an embodiment, the first device includes anex vivo device. In an embodiment, the second device includes a devicesubstantially similar to the first device. In an embodiment, the seconddevice includes a device substantially dissimilar to the first device.In an embodiment, the third device includes a device substantiallysimilar to the first device. In an embodiment, the third device includesa device substantially different from the first device. In anembodiment, the fourth device includes a device substantially similar tothe first device. In an embodiment, the fourth device includes a devicesubstantially different from to the first device.

In an embodiment of the alternative embodiment, the image coregistrationcircuit 2328 is configured to coregister the location of the firstdepiction of the region of interest relative to the second depiction ofthe region of interest, the coregistration is at least partially basedon the first spatial relationship and the second spatial relationship.In an embodiment, the image coregistration circuit is configured tocoregister the first depiction of the region of interest and the seconddepiction of the region of interest. The coregistration includesrelative orientations of the first depiction of the region of interestand the second depiction of the region of interest. The registration isat least partially based on the first spatial relationship and thesecond spatial relationship. In an embodiment, the image coregistrationcircuit is configured to coregister the first depiction of the region ofinterest and the second depiction of the region of interest. Thecoregistration includes a registration of relative distortions of theregion of interest between the first depiction of the region of interestand the second depiction of the region of interest. In an embodiment,the image coregistration circuit is configured to coregister the firstdepiction of the region of interest and the second depiction of theregion of interest. The coregistration includes a spatial translation ofthe second depiction of the region of interest to substantially alignwith the first depiction of the region of interest. The coregistrationis at least partially based on the first spatial relationship and thesecond spatial relationship.

In an embodiment of the alternative embodiment, the system 2320 includesa registration circuit 2326 configured to register the first depictionof the region of interest relative to the landmark subsurface feature ofthe mammalian body part at least partially based on the first spatialrelationship, and to register the second depiction of the region ofinterest relative to the landmark subsurface feature of the mammalianbody part at least partially based on the second spatial relationship.In an embodiment, the image coregistration circuit 2328 is configured tocoregister the first depiction of the region of interest and the seconddepiction of the region of interest. The coregistration is at leastpartially based on the registration of the first depiction of the regionof interest relative to the landmark subsurface feature of the mammalianbody part and on the registration of the second depiction of the regionof interest relative to the landmark subsurface feature of the mammalianbody part.

In an embodiment of the alternative embodiment, the system 2320 includesthe coordinate analysis circuit 2324 configured to determine a spatialrelationship of the first depiction of the region of interest relativeto the landmark subsurface feature of the mammalian body part, and todetermine a spatial relationship of the second depiction of the regionof interest to the landmark subsurface feature of the mammalian bodypart. In an embodiment, the image coregistration circuit 2328 isconfigured to coregister the first depiction of the region of interestand the second depiction of the region of interest, the coregistrationis at least partially based on the determined spatial relationship ofthe first depiction of the region of interest relative to the landmarksubsurface feature of the mammalian body part, and the determinedspatial relationship of the second depiction of the region of interestto the landmark subsurface feature of the mammalian body part.

In an embodiment of the alternative embodiment, the computer-readablemedia 235 is configured to maintain and provide access to informationaldata corresponding to the coregistration of the first depiction of theregion of interest and the second depiction of the region of interest.In an embodiment, the alternative embodiment of the system 2320 includesa communication circuit 2342 configured to output a signal usable indisplaying a human-perceivable indication of the informational data.

FIG. 57 illustrates an example operational flow 2700. The operationalflow includes a start operation. A first reception operation 2710includes receiving a reference medical image that includes a firstdepiction of a region of interest of a mammalian body part during afirst condition. A second reception operation 2720 includes receiving atarget medical image that includes a second depiction the region ofinterest of the mammalian body part during a second condition. A thirdreception operation 2730 includes receiving a first data indicative of afirst spatial relationship between a landmark subsurface feature of themammalian body part and the region of interest during the firstcondition. A fourth reception operation 2740 includes receiving a seconddata indicative of a second spatial relationship between the landmarksubsurface feature of the mammalian body part and the region of interestduring the second condition. In an embodiment, at least one of the firstreception operation, the second reception operation, the third receptionoperation, or the fourth reception operation may be implemented usingthe receiver circuit 2322 of FIG. 49. A coregistration operation 2750includes coregistering the first depiction of the region of interest andthe second depiction of the region of interest, the coregistration is atleast partially based on the first spatial relationship and the secondspatial relationship. In an embodiment, the coregistration operation maybe implemented using the image coregistration circuit 2328 of FIG. 49. Astorage operation 2760 includes maintaining in a computer-readable mediainformational data corresponding to the coregistration of the firstdepiction of the region of interest and the second depiction of theregion of interest. In an embodiment, the storage operation may beimplemented using the computer-readable media 235 of FIG. 3. Theoperational flow includes an end operation.

In an embodiment, the mammalian body part includes a cavity or lumen ofa mammalian body part. In an embodiment, the mammalian body partincludes a surface of a cavity or lumen of a mammalian body part. In anembodiment, the second spatial relationship is substantially the same asthe first spatial relationship. In an embodiment, the second spatialrelationship is substantially different from the first spatialrelationship.

FIG. 58 illustrates alternative embodiments of the first receptionoperation 2710 and the second reception operation 2720 of theoperational flow 2700 of FIG. 57. In an embodiment, the first receptionoperation may include at least one additional embodiment, such as anoperation 2711 or an operation 2712. The operation 2711 includesreceiving a reference medical image that was acquired by abody-insertable device and that includes a first depiction of a regionof interest of a mammalian body part during a first condition. Theoperation 2712 includes receiving a reference medical image that wasacquired by an ex vivo device and that includes a first depiction of aregion of interest of a mammalian body part during a first condition.

In an embodiment, the second reception operation may include at leastone additional embodiment, such as an operation 2721 or an operation2722. The operation 2721 includes receiving a target medical imageacquired by a body-insertable device and includes a second depiction theregion of interest of the mammalian body part during a second condition.The operation 2722 includes receiving a target medical image acquired byan ex vivo device and includes a second depiction the region of interestof the mammalian body part during a second condition.

FIG. 59 illustrates alternative embodiments of the third receptionoperation 2730 and the fourth reception operation 2740. In anembodiment, the third reception operation may include at least oneadditional embodiment, such as an operation 2731 or an operation 2732.The operation 2731 includes receiving a first data acquired by abody-insertable device and indicative of a first spatial relationshipbetween a landmark subsurface feature of the mammalian body part and theregion of interest during the first condition. The operation 2732includes receiving a first data acquired by an ex vivo device andindicative of a first spatial relationship between a landmark subsurfacefeature of the mammalian body part and the region of interest during thefirst condition.

In an embodiment, the fourth operation may include an operation 2741 oran operation 2742. The operation 2741 includes receiving a second dataacquired by a body-insertable device and indicative of a second spatialrelationship between the landmark subsurface feature of the mammalianbody part and the region of interest during the second condition. Theoperation 2742 includes receiving a second data acquired by an ex vivodevice and indicative of a second spatial relationship between thelandmark subsurface feature of the mammalian body part and the region ofinterest during the second condition.

FIG. 60 illustrates an alternative embodiment of the coregistrationoperation 2750. In an embodiment, the coregistration operation mayinclude at least one additional embodiment, such as an operation 2751 oran operation 2752. The operation 2751 includes spatially transformingthe region of interest depicted by the target digital image tosubstantially align with the region of interest depicted by thereference image, the spatially transforming is at least partially basedon the first spatial relationship and the second spatial relationship.The operation 2752 includes coregistering the first depiction of theregion of interest and the second depiction of the region of interest,the coregistration is at least partially based on the first spatialrelationship or the second spatial relationship.

FIG. 61 illustrates an alternative embodiment of the operational flow2700 of FIG. 57. In an embodiment, the operational flow may include atleast one additional embodiment 2770. The at least one additionalembodiment may include an operation 2772 or an operation 2774. In anembodiment, the coregistration operation 2750 may include at least oneadditional embodiment, such as an operation 2753 or an operation 2754.The operation 2772 includes registering both the first depiction of theregion of interest and the second depiction of the region of interestrelative to the landmark subsurface feature of the mammalian body part.The registering is at least partially based on the first spatialrelationship and the second spatial relationship. The operation 2753includes coregistering the first depiction of the region of interest andthe second depiction of the region of interest. The coregistering is atleast partially based upon the registering both the first depiction ofthe region of interest and the second depiction of the region ofinterest relative to the landmark subsurface feature of the mammalianbody part. The operation 2774 includes determining the first spatialrelationship of the first depiction of the region of interest relativeto the landmark subsurface feature of the mammalian body part, anddetermining the second spatial relationship of the second depiction ofthe region of interest to the landmark subsurface feature of themammalian body part. The operation 2754 includes registering both thefirst depiction of the region of interest and the second depiction ofthe region of interest relative to the landmark subsurface feature ofthe mammalian body part. The registering is at least partially based onthe determined first spatial relationship and the determined secondspatial relationship.

FIG. 62 illustrates an alternative embodiment of the storage operation2760 of FIG. 57. In an embodiment, the storage operation may include atleast one additional embodiment, such as an operation 2761. Theoperation 2761 includes maintaining in a computer-readable media andproviding electronic access to informational data corresponding to thecoregistration of the first depiction of the region of interest and thesecond depiction of the region of interest.

FIG. 63 illustrates an alternative embodiment of the operational flow2700 of FIG. 57. The operational flow may include at least oneadditional embodiment 2780. The at least one additional embodiment mayinclude an operation 2781, an operation 2782, an operation 2783, anoperation 2784, or an operation 2785. The operation 2781 includesoutputting a signal usable in displaying a human-perceivable indicationof the coregistration of the first depiction of the region of interestand the second depiction of the region of interest. The operation 2782includes transforming the informational data into a particular visualrepresentation of the coregistration of the first depiction of theregion of interest and the second depiction of the region of interest.The operation 2783 includes transforming the informational data into aparticular visual representation of the relative spatial relationshipsof the first depiction of the region of interest and the seconddepiction of the region of interest. The operation 2784 includesoutputting the informational data. The operation 2785 includes providinga notification that is at least partially based on the informationaldata to at least one of a human, computer, or system.

FIG. 64 illustrates an example computer program product. The computerprogram product includes a computer-readable media 2810 bearing programinstructions 2820. The program instructions, when executed by aprocessor of a computing device, cause the computing device to perform aprocess. The process includes receiving a reference medical image thatincludes a first depiction of a region of interest of a mammalian bodypart during a first condition. The process includes receiving a targetmedical image that includes a second depiction the region of interest ofthe mammalian body part during a second condition. The process includesreceiving a first data indicative of a first spatial relationshipbetween a landmark subsurface feature of the mammalian body part and theregion of interest during the first condition. The process includesreceiving a second data indicative of a second spatial relationshipbetween the landmark subsurface feature of the mammalian body part andthe region of interest during the second condition. The process includescoregistering the first depiction of the region of interest and thesecond depiction of the region of interest. The process includes storingin another computer-readable media operably coupled with the processorinformational data corresponding to the coregistration of the firstdepiction of the region of interest and the second depiction of theregion of interest.

In an embodiment, the computer-readable media 2810 includes a tangiblecomputer-readable media 2812. In an embodiment, the computer-readablemedia includes a communications medium 2814.

FIG. 65 illustrates an alternative embodiment of the programinstructions, when executed by a processor of a computing device, causethe computing device to perform a process. In an embodiment, the processfurther includes 2822 outputting the informational data. In anembodiment, the process further includes 2824 outputting a signaluseable in displaying a human-perceivable indication of thecoregistration of the first depiction of the region of interest and thesecond depiction of the region of interest. In an embodiment, theprocess further includes 2826 transforming the informational data into aparticular visual depiction of the coregistration of the first depictionof the region of interest and the second depiction of the region ofinterest. In an embodiment, the process further includes 2828 providinga notification that is at least partially based on the informationaldata to at least one of a human, computer, or system.

FIG. 66 illustrates an example system 2900. The system includes 2910means for receiving a reference medical image that includes a firstdepiction of a region of interest of a mammalian body part during afirst condition. The system includes means 2920 for receiving a targetmedical image that includes a second depiction the region of interest ofthe mammalian body part during a second condition. The system includes2930 means for receiving a first data indicative of a first spatialrelationship between a landmark subsurface feature of the mammalian bodypart and the region of interest during the first condition. The systemincludes means 2940 for receiving a second data indicative of a secondspatial relationship between the landmark subsurface feature of themammalian body part and the region of interest during the secondcondition. The system includes means 2950 for coregistering the firstdepiction of the region of interest and the second depiction of theregion of interest. The system includes means 2960 for persistentlymaintaining computer-readable informational data corresponding to thecoregistration of the first depiction of the region of interest and thesecond depiction of the region of interest.

FIG. 67 illustrates an example environment 3000. The environmentincludes the mammalian body part 210 of the mammal 205, and a system3020. The system includes a receiver circuit 3022. The receiver circuitis configured to receive (i) a first reference image that includes afirst landmark subsurface feature of a mammalian body part, (ii) asecond reference image that includes a second landmark subsurfacefeature of the mammalian body part, and (iii) data indicative of aspatial relationship between the first landmark subsurface feature andthe second landmark subsurface feature. At least one of the firstreference image, the second reference image, and the data may beacquired using an ex vivo imaging system, such as an MRI, CAT scan,fluoroscope, or other externally sourced imaging technique operable toacquire digital representation of landmark subsurface features of themammalian body part. At least one of the first reference image, thesecond reference image, and the data may be acquired using an internalimage acquisition device moved through the cavity or lumen. In anembodiment, for example, the internal image acquisition device mayinclude the body-insertable device 280. In an embodiment, the data maybe acquired using an internal image acquisition device having a 3-axis,4-axis, 5-axis, or 6-axis accelerometers to signal translational androtational movements by the internal image acquisition device. Thesystem includes a coordinate analysis circuit 3024 configured todetermine a common frame of reference that is at least partially basedon the first landmark subsurface feature or the second landmarksubsurface feature. The system includes the registration circuit 3026configured to register the first landmark subsurface feature and thesecond landmark subsurface feature at least partially based on thecommon frame of reference. The system includes the computer-readablemedia 235 configured to maintain informational data corresponding to theregistration of the first landmark subsurface feature and the secondlandmark subsurface feature.

In an embodiment, the receiver circuit 3022 is configured to receive (i)a first reference image that includes a first landmark subsurfacefeature of a cavity or lumen of a mammalian body part, (ii) a secondreference image that includes a second landmark subsurface feature ofthe cavity or lumen of the mammalian body part, and (iii) dataindicative of a spatial relationship between the first landmarksubsurface feature and the second landmark subsurface feature. In anembodiment, the receiver circuit is configured to receive (i) a firstreference image that includes a first machine-discernable landmarksubsurface feature of a mammalian body part, (ii) a second referenceimage that includes a second machine-discernable landmark subsurfacefeature of the mammalian body part, and (iii) data indicative of aspatial relationship between the first landmark subsurface feature andthe second landmark subsurface feature. In an embodiment, the receivercircuit is configured to receive (i) a first reference image thatincludes a first landmark subsurface feature of a mammalian body partacquired by a first device, (ii) a second reference image that includesa second landmark subsurface feature of the mammalian body part acquiredby a second device, and (iii) data indicative of a spatial relationshipbetween the first landmark subsurface feature and the second landmarksubsurface feature.

In an embodiment, the first device includes a body-insertable device. Inan embodiment, the first device includes an ex vivo device. In anembodiment, the second device includes a device substantially similar tothe first device. In an embodiment, the second device includes a devicesubstantially dissimilar to the first device.

In an embodiment, the receiver circuit 3022 is configured to receive (i)a first reference image that includes a first landmark subsurfacefeature of a mammalian body part, (ii) a second reference image thatincludes a second landmark subsurface feature of the mammalian bodypart, and (iii) data indicative of a determinable, estimable, orinferable spatial relationship between the first landmark subsurfacefeature and the second landmark subsurface feature. In an embodiment thereceiver circuit is configured to receive (i) a first reference imagethat includes a first landmark subsurface feature of a mammalian bodypart and a third landmark subsurface feature, and (ii) a secondreference image that includes a second landmark subsurface feature ofthe mammalian body part, and the third landmark subsurface feature. Forexample, FIG. 42 illustrates an example of a common third landmarksubsurface feature in a first reference image and a second referenceimage. In FIG. 42, the reference image 1992C includes within its fieldof view 1994C the landmark subsurface feature 216D and the landmarksubsurface feature 216C. The reference image 1992A includes within itsfield of view 1994A the landmark subsurface feature 216A and thelandmark subsurface feature 216C. In an embodiment, the coordinateanalysis circuit 3024 is configured to determine a common frame ofreference at least partially based on the first landmark subsurfacefeature, the second landmark subsurface feature, or the third landmarksubsurface feature.

Returning to FIG. 67, in an embodiment, the receiver circuit 3022 isconfigured to receive (i) a first reference image that includes a firstlandmark subsurface feature of a mammalian body part, and an anomaly ofthe mammalian body part, and (ii) a second reference image that includesa second landmark subsurface feature of the mammalian body part, and theanomaly of the mammalian body part. In an embodiment, the receivercircuit is configured to receive (i) a first reference image having afirst field of view and including a first landmark subsurface feature ofa mammalian body part, and (ii) a second reference image having a secondfield of view and including a second landmark subsurface feature of themammalian body part, a portion of the second field of view coextensivewith the first field of view. The portion of the second field of viewcoextensive with the first field of view may include an edge overlap.The portion of the second field of view coextensive with the first fieldof view may include another feature common to both the first field ofview and the second field of view. In an embodiment, the coordinateanalysis circuit 3024 is configured to determine a common frame ofreference at least partially based on the first landmark subsurfacefeature, the second landmark subsurface feature, or the portion of thesecond field of view coextensive with the first field of view. In anembodiment, the receiver circuit is configured to receive (i) a firstreference image that includes a first landmark subsurface feature of amammalian body part, (ii) a second reference image that includes asecond landmark subsurface feature of the mammalian body part, and (iii)a third reference image that includes the first landmark subsurfacefeature and the second landmark subsurface feature. For example, thethird reference image may be acquired by fluoroscope or other ex vivoimaging device. In an embodiment, the receiver circuit is configured toreceive a reference image that includes a first landmark subsurfacefeature of a mammalian body part, a second landmark subsurface featureof the mammalian body part, and data indicative of a spatialrelationship between the first landmark subsurface feature and thesecond landmark subsurface feature. In an embodiment, the receivercircuit is configured to determine a common frame of reference at leastpartially based on the first landmark subsurface feature, the secondlandmark subsurface feature, or the data indicative of a spatialrelationship between the first landmark subsurface feature and thesecond landmark subsurface feature.

In an embodiment, the coordinate analysis circuit 3024 is configured todetermine a common frame of reference and a coordinate system at leastpartially based on the first landmark subsurface feature or the secondlandmark subsurface feature. In an embodiment, the coordinate analysiscircuit is configured to determine a common frame of reference anchoredin the first landmark subsurface feature or the second landmarksubsurface feature. In an embodiment, the coordinate analysis circuit isconfigured to determine a coordinate reference system at least partiallybased on the first landmark subsurface feature or the second landmarksubsurface feature.

In an embodiment, the registration circuit 3026 is configured toregister the first landmark subsurface feature the second landmarksubsurface feature, the registration is at least partially based on thedetermined common frame of reference and on a spatial relationship ofthe first landmark subsurface feature and the second landmark subsurfacefeature. In an embodiment, the registration circuit is configured toregister a spatial relationship of the first landmark subsurface featurerelative to the second landmark subsurface feature at least partiallybased on the common frame of reference. In an embodiment, theregistration circuit is configured to register the first landmarksubsurface feature relative to the second landmark subsurface feature.The registration includes an orientation of the first landmarksubsurface feature relative to the second landmark subsurface feature,and the registration is at least partially based on the common frame ofreference.

In an embodiment, the system includes 3020 includes a communicationcircuit 3042 configured to output the informational data. In anembodiment, the system includes a communication circuit configured toprovide a notification that is at least partially based on theinformational data to at least one of a human, computer, or system.

In an embodiment, the system 3020 includes an atlas generation circuit3028 configured to generate a subsurface feature atlas of the mammalianbody part. The subsurface feature atlas is at least partially based onthe informational data. In an embodiment, the system includes acommunication circuit 3042 configured to output informational datacorresponding to the subsurface feature atlas of the mammalian bodypart. In an embodiment, the computer-readable media 235 is configured tomaintain informational data corresponding to the subsurface featureatlas of the mammalian body part. In an embodiment, the system includesa communications circuit 3042 configured to output a signal usable indisplaying a human-perceivable depiction of the subsurface feature atlasof the mammalian body part. The human-perceivable depiction may includean audio or a visual human-perceivable depiction.

FIG. 68 illustrates an example operational flow 3100. The operationalflow includes a start operation. A first reception operation 3110includes receiving a first reference image that includes a firstlandmark subsurface feature of a mammalian body part. A second receptionoperation 3120 includes receiving a second reference image that includesa second landmark subsurface feature of the mammalian body part. A thirdreception operation 3130 includes receiving data indicative of a spatialrelationship between the first landmark subsurface feature and thesecond landmark subsurface feature. In an embodiment, at least one ofthe first reception operation, the second reception operation, or thethird reception operation may be implemented using the receiver circuit3022 of FIG. 67. A reference operation 3140 includes determining acommon frame of reference is at least partially based on the firstlandmark subsurface feature or the second landmark subsurface feature.In an embodiment, the reference operation may be implemented using thecoordinate analysis circuit 3024 of FIG. 67. A registering operation3150 includes registering the first landmark subsurface feature and thesecond landmark subsurface feature at least partially based on thecommon frame of reference. In an embodiment, the registering operationmay be implemented using the registration circuit 3026 of FIG. 67. Astorage operation 3160 includes maintaining in a computer-readable mediainformational data corresponding to the registration of the firstlandmark subsurface feature and the second landmark subsurface feature.In an embodiment, the storage operation may be implemented using thecomputer-readable media 235 of FIG. 67. The operational flow includes anend operation. In an embodiment, the operational flow may include amapping operation 3170 generating a subsurface feature atlas of themammalian body part that is at least partially based on the registrationof the first landmark subsurface feature and the second landmarksubsurface feature.

FIG. 69 illustrates an alternative embodiment of the first receptionoperation 3110 of FIG. 68. The first reception operation may include atleast one additional embodiment. The at least one additional embodimentmay include an operation 3111, an operation 3112, or an operation 3113.The operation 3111 includes receiving a first reference image thatincludes a first landmark subsurface feature of a cavity or lumen of amammalian body part. The operation 3112 includes receiving firstreference image that was acquired by a body-insertable device andincludes a first landmark subsurface feature of a mammalian body part.The operation 3113 includes receiving first reference image that wasacquired by an ex vivo device and includes a first landmark subsurfacefeature of a mammalian body part.

FIG. 70 illustrates an alternative embodiment of the third receptionoperation 3130 of FIG. 68. The third reception operation may include atleast one additional embodiment. The at least one additional embodimentmay include an operation 3131, an operation 3132, an operation 3133, oran operation 3134. The operation 3131 includes receiving a thirdreference image indicative of a spatial relationship between the firstlandmark subsurface feature and the second landmark subsurface feature.The operation 3132 includes receiving a third reference image having afield of view indicative of a spatial relationship between the firstlandmark subsurface feature and the second landmark subsurface feature.The operation 3133 includes receiving a third reference image that wasacquired by a body-insertable device and indicative of a spatialrelationship between the first landmark subsurface feature and thesecond landmark subsurface feature. The operation 3134 includesreceiving a third reference image that was acquired by an ex vivo deviceand indicative of a spatial relationship between the first landmarksubsurface feature and the second landmark subsurface feature.

FIG. 71 illustrates an alternative embodiment of the operational flow3000 of FIG. 68. In an embodiment, the registration operation 3150 mayinclude at least one additional embodiment, such as an operation 3151 oran operation 3152. The operation 3151 includes registering the firstlandmark subsurface feature and the second landmark subsurface feature,the registration is at least partially based on the determined commonframe of reference and on a spatial relationship of the first landmarksubsurface feature and the second landmark subsurface feature. Theoperation 3152 includes registering a spatial relationship of the firstlandmark subsurface feature relative to the second landmark subsurfacefeature, the registration is at least partially based on the determinedcommon frame of reference. In an embodiment, the storage operation 3160may include at least one additional embodiment, such as an operation3161 or an operation 3162. The operation 3161 includes maintaining in acomputer-readable media and providing electronic access to informationaldata corresponding to the registration of the first landmark subsurfacefeature and the second landmark subsurface feature. The operation 3162includes maintaining in a computer-readable media informational datacorresponding to the generated subsurface feature atlas of the mammalianbody part.

FIG. 72 illustrates an alternative embodiment of the operational flow3000 of FIG. 68. The operational flow may include at least oneadditional embodiment 3180. The at least one additional embodiment mayinclude an operation 3181, an operation 3182, an operation 3183, anoperation 3184, or an operation 3185. The operation 3181 includesoutputting a signal useable in displaying a human-perceivable indicationof the registration of the first landmark subsurface feature and thesecond landmark subsurface. The operation 3182 includes transforming theinformational data into a particular visual depiction of theregistration of the first landmark subsurface feature and the secondlandmark subsurface feature. The operation 3183 includes transformingthe informational data into a particular visual depiction of theregistration of the relative spatial relationships of the first landmarksubsurface feature and the second landmark subsurface feature. Theoperation 3184 includes outputting the informational data. The operation3185 includes providing a notification that is at least partially basedon the informational data to at least one of a human, computer, orsystem.

FIG. 73 illustrates an example computer program product 3200. Theprogram product includes a computer-readable medium 3210 bearing programinstructions 3220. The program instructions, when executed by aprocessor of a computing device, cause the computing device to perform aprocess. The process includes receiving a first reference image thatincludes a first landmark subsurface feature of a mammalian body part.The process includes receiving a second reference image that includes asecond landmark subsurface feature of the mammalian body part. Theprocess includes receiving data indicative of a spatial relationshipbetween the first landmark subsurface feature and the second landmarksubsurface feature. The process includes determining a common frame ofreference that is at least partially based on the first landmarksubsurface feature or the second landmark subsurface feature. Theprocess includes registering the first landmark subsurface feature andthe second landmark subsurface feature at least partially based on thecommon frame of reference. The process includes storing in anothercomputer-readable medium operably coupled with the processorinformational data corresponding to the registration of the firstlandmark subsurface feature and the second landmark subsurface feature.

In an embodiment, the computer-readable media 3210 includes a tangiblecomputer-readable media 3212. In an embodiment, the computer-readablemedia includes a communications medium 3214.

In an embodiment, the registering process includes a process 3222registering the first landmark subsurface feature and the secondlandmark subsurface feature. The registration is at least partiallybased on the determined common frame of reference and on a spatialrelationship of the first landmark subsurface feature and the secondlandmark subsurface feature. In an embodiment, the process furtherincludes 3224 generating a subsurface feature atlas of the mammalianbody part that is at least partially based on the registration of thefirst landmark subsurface feature and the second landmark subsurfacefeature.

FIG. 74 illustrates an alternative embodiment of the process 3220 of thecomputer program product 3200 of FIG. 73. In an embodiment, the processfurther includes 3226 outputting the informational data. In anembodiment, the process further includes 3228 outputting a signaluseable in displaying a human-perceivable indication of the registrationof the first landmark subsurface feature and the second landmarksubsurface feature. In an embodiment, the process further includes 3232transforming the informational data into a signal usable in providing aparticular visual depiction of the registration of the first landmarksubsurface feature and the second landmark subsurface feature. In anembodiment, the process further includes 3234 providing a notificationthat is at least partially based on the informational data to at leastone of a human, computer, or system.

FIG. 75 illustrates an example system 3300. The system includes means3310 for receiving a first reference image that includes a firstlandmark subsurface feature of a mammalian body part. The systemincludes means 3320 for receiving a second reference image that includesa second landmark subsurface feature of the mammalian body part. Thesystem includes means 3330 for receiving data indicative of a spatialrelationship between the first landmark subsurface feature and thesecond landmark subsurface feature. The system includes means 3340 fordetermining a common frame of reference that is at least partially basedon the first landmark subsurface feature or the second landmarksubsurface feature. The system includes means 3350 for registering thefirst landmark subsurface feature and the second landmark subsurfacefeature at least partially based on the common frame of reference. Thesystem includes means 3360 means for persistently maintainingcomputer-readable informational data corresponding to the registrationof the first landmark subsurface feature and the second landmarksubsurface feature. In an alternative embodiment, the system includesmeans 3370 for generating a subsurface feature atlas of the mammalianbody part that is at least partially based on the registration of thefirst landmark subsurface feature and the second landmark subsurfacefeature.

Returning to FIG. 67, FIG. 67 illustrates an alternative embodiment ofthe system 3020. The alternative embodiment includes the coordinateanalysis circuit 3024, the registration circuit 3026, and thecomputer-readable media 235. In the alternative embodiment, thecoordinate analysis circuit 3024 is configured to determine a commonframe of reference at least partially based on a first landmarksubsurface feature of a mammalian body part 210 or the second landmarksubsurface feature of the mammalian body part. In the alternativeembodiment, the registration circuit 3026 is configured to register thefirst landmark subsurface feature and the second landmark subsurfacefeature, the registration is at least partially based on the commonframe of reference. In the alternative embodiment, the computer-readablemedia 235 is configured to maintain informational data corresponding tothe registration of the first landmark subsurface feature and the secondlandmark subsurface feature.

In an embodiment of the alternative embodiment of the system 3020, thecoordinate analysis circuit 3024 is configured to determine a commonframe of reference at least partially based on a first landmarksubsurface feature of a mammalian body part and the second landmarksubsurface feature of the mammalian body part. In an embodiment of thealternative embodiment, the coordinate analysis circuit is configured todetermine a common frame of reference at least partially based on afirst landmark subsurface feature of a cavity or lumen of a mammalianbody part or the second landmark subsurface feature of the cavity orlumen of the mammalian body part.

In an embodiment of the alternative embodiment of the system 3020, theregistration circuit 3026 is configured to register the first landmarksubsurface feature and the second landmark subsurface feature. Theregistration is at least partially based on the common frame ofreference and on data indicative of a spatial relationship between thefirst landmark subsurface feature and the second landmark subsurfacefeature. In an embodiment of the alternative embodiment of the system,the atlas generation circuit 3028 is configured to generate a subsurfacefeature atlas of the mammalian body part. The subsurface feature atlasis at least partially based on the registration of the first landmarksubsurface feature and the second landmark subsurface feature. In anembodiment of the alternative embodiment of the system, thecomputer-readable media is configured to maintain informational datacorresponding to the subsurface feature atlas of the mammalian bodypart.

In an embodiment of the alternative embodiment of the system 3020, thecommunication circuit 3042 is configured to output the informationaldata. In an embodiment of the alternative embodiment of the system, thecommunication circuit is configured to provide a notification that is atleast partially based on the informational data to at least one of ahuman, computer, or system. In an embodiment of the alternativeembodiment, the system includes the computing device 292 configured todisplay on the screen 294 a human-perceivable depiction of thesubsurface feature atlas of the mammalian body part 210.

FIG. 76 illustrates an example operational flow 3400. The operationalflow includes a start operation. The operational flow includes areference operation 3410. The reference operation includes determining acommon frame of reference at least partially based on a first landmarksubsurface feature of a mammalian body part or a second landmarksubsurface feature of the mammalian body part. In an embodiment, thereference operation may be implemented using the coordinate analysiscircuit 3024 described in conjunction with FIG. 67. A registrationoperation 3420 includes registering the first landmark subsurfacefeature and the second landmark subsurface feature. The registration isat least partially based on the common frame of reference. Theregistration operation may be implemented using the registration circuit3026 described in conjunction with FIG. 67. A storage operation 3430includes maintaining in a computer-readable media informational datacorresponding to the registration of the first landmark subsurfacefeature and the second landmark subsurface feature. The storageoperation may be implemented using the computer-readable media 235described in conjunction with FIG. 3. The operational flow includes anend operation.

In an embodiment, the operational flow 3400 includes a map operation3440. The map operation includes generating a subsurface feature atlasof the mammalian body part that is at least partially based on theregistration of the first landmark subsurface feature and the secondlandmark subsurface feature.

FIG. 77 illustrates an alternative embodiment of the example operationalflow 3400 of FIG. 76. In an embodiment, the registration operation 3420includes at least one additional embodiment, such as an operation 3422.The operation 3422 includes registering the first landmark subsurfacefeature and the second landmark subsurface feature. The registration isat least partially based on the determined common frame of reference andon a spatial relationship of the first landmark subsurface feature andthe second landmark subsurface feature. In an embodiment, the storageoperation 3430 includes at least one additional embodiment, such as anoperation 3432. The operation 3431 includes maintaining in acomputer-readable media informational data corresponding to (i) to theregistration of the first landmark subsurface feature and the secondlandmark subsurface feature and (ii) to the subsurface feature atlas ofthe mammalian body part.

FIG. 78 illustrates an example computer program product 3600. Thecomputer program product includes a computer-readable media 3610 bearingprogram instructions 3620. The program instructions, when executed by aprocessor of a computing device, cause the computing device to perform aprocess. The process includes determining a common frame of referencethat is at least partially based on a first landmark subsurface featureof a mammalian body part or the second landmark subsurface feature ofthe mammalian body part. The process includes registering the firstlandmark subsurface feature and the second landmark subsurface feature.The registration is at least partially based on the common frame ofreference. The process includes storing in another computer-readablemedia operably coupled with the processor informational datacorresponding to the registration of the first landmark subsurfacefeature and the second landmark subsurface feature.

In an embodiment, the computer-readable media 3610 includes a tangiblecomputer-readable media 3612. In an embodiment, the computer-readablemedia includes a communications media 3614.

In an embodiment, the registering includes 3622 registering the firstlandmark subsurface feature and the second landmark subsurface feature,the registration is at least partially based on the determined commonframe of reference and on a spatial relationship of the first landmarksubsurface feature and the second landmark subsurface feature. In anembodiment, the process further includes 3624 generating a subsurfacefeature atlas of the mammalian body part. The subsurface atlas is atleast partially based on the registration of the first landmarksubsurface feature and the second landmark subsurface feature.

FIG. 79 illustrates an example system 3700. The system includes means3710 for determining a common frame of reference that is at leastpartially based on a first landmark subsurface feature of a mammalianbody part or the second landmark subsurface feature of the mammalianbody part. The system includes means 3720 for registering the firstlandmark subsurface feature and the second landmark subsurface feature.The registration is at least partially based on the common frame ofreference. The system includes means 3730 for persistently maintainingin a computer-readable media informational data corresponding to theregistration of the first landmark subsurface feature and the secondlandmark subsurface feature.

FIG. 80 illustrates an example environment 3800. The environmentincludes the mammalian body part 210 of the mammal 205, and a system3820. The system includes a receiver circuit 3822 configured to receiveat least two reference images. Each reference image of the at least tworeference images including a respective landmark subsurface feature of amammalian body part, illustrated as the mammalian body part 210. Thereceiver circuit is also configured to receive data indicative of aspatial relationship among each respective landmark subsurface featureof the at least two reference images. For example, FIG. 42 illustratesan embodiment including the reference image 1992A, which includes thelandmark subsurface feature 216A, and the reference image 1992B, whichincludes the landmark subsurface feature 216B. FIG. 42 also illustratesthe spatial relationship 213C among the landmark subsurface feature 216Aand the landmark subsurface feature 216B. Continuing with FIG. 80, thesystem includes a coordinate analysis circuit 3824 configured todetermine a common frame of reference that is at least partially basedon a landmark subsurface feature of the mammalian body part included ina reference image of the at least two reference images. The systemincludes a registration circuit 3826 configured to register therespective landmark subsurface feature of the mammalian body partincluded in each reference image of the at least two reference images.The registration is at least partially based on the determined commonframe of reference and on the data indicative of a spatial relationshipamong each respective landmark subsurface feature of the at least tworeference images. The system includes the computer-readable media 235configured to maintain informational data corresponding to theregistration of the respective landmark subsurface feature of themammalian body part included in each reference image of the at least tworeference images.

In an embodiment, the receiver circuit 3822 is configured to receive (i)at least two reference images, and (ii) data indicative of a spatialrelationship between each respective landmark subsurface feature of theat least two reference images. Each reference image of the at least tworeference images includes a respective landmark subsurface feature of acavity or lumen of a mammalian body part. In an embodiment, the receivercircuit is configured to receive (i) at least two reference images, and(ii) data indicative of a spatial relationship between each respectivelandmark subsurface feature of the at least two reference images. Eachreference image of the at least two reference images includes arespective machine-discernible landmark subsurface feature of amammalian body part. In an embodiment, the receiver circuit isconfigured to receive (i) at least two reference images and (ii) datauseable in determining or inferring a spatial relationship between eachrespective landmark subsurface feature of the at least two referenceimages. Each reference image of the at least two reference imagesincludes a respective landmark subsurface feature of a mammalian bodypart. In an embodiment, the receiver circuit is configured to receive(i) at least two reference images. Each reference image of the at leasttwo reference images includes a respective landmark subsurface featureof a mammalian body part. The receiver is also configured to receive(ii) data indicative of a spatial relationship between a first landmarksubsurface feature of a first reference image of the at least tworeference images and a second landmark subsurface feature of a secondreference image of the at least two reference images. For example, thedata indicative of a spatial relationship may include data indicative ofan overlapped third landmark subsurface feature. In an embodiment, thereceiver circuit is configured to receive (i) at least two referenceimages. Each reference image of the at least two reference imagesincludes a respective landmark subsurface feature of a mammalian bodypart. The receiver circuit is also configured to receive (ii) dataindicative of a spatial relationship between each respective landmarksubsurface feature of the at least two reference images. The dataindicative of an edge content overlap of an edge content of a field ofview of a first reference image of the at least two reference images andan edge content of field of view of a second reference image of the atleast two reference images. In an embodiment, the coordinate analysiscircuit 3824 is configured to determine a common frame of reference thatis at least partially based on the edge content overlap between the edgecontent of the field of view of the first reference image of the atleast two reference images and the edge content of the field of view ofthe second reference image of the at least two reference images.

In an embodiment, the coordinate analysis circuit 3824 is configured todetermine a common frame of reference that is at least partially basedon (i) a first landmark subsurface feature of the mammalian body partincluded in the first reference image of the at least two referenceimages, and (ii) a second landmark subsurface feature of the mammalianbody part included in the second reference image of the at least tworeference images. In an embodiment, the registration circuit 3826 isconfigured to register a spatial relationship of the respective landmarksubsurface feature of the mammalian body part included in each referenceimage of the at least two reference images. The registration is at leastpartially based on the determined common frame of reference and on thedata indicative of spatial relationships between the at least twolandmark subsurface features of a mammalian body part. In an embodiment,the registration circuit is configured to register a spatialrelationship and an orientation of the respective landmark subsurfacefeature of the mammalian body part included in each reference image ofthe at least two reference images. The registration is at leastpartially based on the determined common frame of reference and on thedata indicative of spatial relationships between the at least twolandmark subsurface features of a mammalian body part.

In an embodiment, the system 3820 includes an atlas generation circuit3828 configured generate a subsurface feature atlas of the mammalianbody part. The subsurface feature atlas includes a spatial relationshipof the respective landmark subsurface feature of the mammalian body partincluded in each reference image of the at least two reference images.The subsurface feature atlas is at least partially based on theregistration of the respective landmark subsurface feature of themammalian body part included in each reference image of the at least tworeference images. In an embodiment, the computer-readable media 235 isconfigured to maintain informational data (i) corresponding to theregistration of the respective landmark subsurface feature of themammalian body part included in each reference image of the at least tworeference images, and (ii) informational data corresponding to thegenerated subsurface feature atlas of the mammalian body part.

FIG. 81 illustrates an example operational flow 3900. The operationalflow includes a start operation. The operational flow includes areception operation 3910. The reception operation includes receiving atleast two reference images, each reference image of the at least tworeference images includes a respective landmark subsurface feature of amammalian body part. The reception operation also includes receivingdata indicative of a spatial relationship between each respectivelandmark subsurface feature of the at least two reference images. In anembodiment, the reception operation may be performed using the receivercircuit 3822 described in conjunction with FIG. 80. A referenceoperation 3920 includes determining a common frame of reference that isat least partially based on a landmark subsurface feature of themammalian body part included in a reference image of the at least tworeference images. In an embodiment, the reference operation may beperformed using the coordinate analysis circuit 3824 described inconjunction with FIG. 80. A registration operation 3930 includesregistering the respective landmark subsurface feature of the mammalianbody part included in each reference image of the at least two referenceimages. The registration is at least partially based on the determinedcommon frame of reference and on the data indicative of spatialrelationships between the at least two landmark subsurface features of amammalian body part. In an embodiment, the registration operation may beimplemented using the registration circuit 3826. A storage operation3940 includes maintaining in a computer-readable media informationaldata corresponding to the registration of the respective landmarksubsurface feature of the mammalian body part included in each referenceimage of the at least two reference images. In an embodiment, thestorage operation may be implemented using the computer-readable media235 described in conjunction with FIG. 80. The operational flow includesan end operation.

In an embodiment, the operational flow 3900 may include at least oneadditional embodiment, such as a mapping operation 3950. The mappingoperation includes generating a subsurface feature atlas of themammalian body part, the subsurface feature atlas includes a spatialrelationship of the respective landmark subsurface feature of themammalian body part included in each reference image of the at least tworeference images. The subsurface feature atlas is at least partiallybased on the registration of the respective landmark subsurface featureof the mammalian body part included in each reference image of the atleast two reference images.

FIG. 82 illustrates an alternative embodiment of the operational flow3900 of FIG. 81. In an embodiment, the reception operation 3910 mayinclude at least one additional embodiment, such as an operation 3911.The operation 3911 includes receiving at least two reference images,each reference image of the at least two reference images includes arespective landmark subsurface feature of a cavity or lumen of amammalian body part. The operation 3911 also includes receiving dataindicative of a respective spatial relationship among each respectivelandmark subsurface feature of the at least two reference images. In anembodiment, the reference operation 3920 may include at least oneadditional embodiment, such as an operation 3921. The operation 3921includes determining a common frame of reference is at least partiallybased on a first landmark subsurface feature of the mammalian body partincluded in a first reference image of the at least two reference imagesand on a second landmark subsurface feature of the mammalian body partincluded in a second reference image of the at least two referenceimages. In an embodiment, the registration operation 3930 may include atleast one additional embodiment. The at least one additional embodimentmay include an operation 3931, an operation 3932, or an operation 3933.The operation 3931 includes registering the respective landmarksubsurface feature of the mammalian body part included in each referenceimage of the at least two reference images. The registration is at leastpartially based on the determined common frame of reference and on thedata indicative of a respective spatial relationship among eachrespective landmark subsurface feature of the at least two referenceimages. The data includes data indicative of a content overlap between acontent of a field of view of a first reference image of the at leasttwo reference images and a content of a field of view of a secondreference image of the at least two reference images. The operation 3932includes registering the respective landmark subsurface feature of themammalian body part included in each reference image of the at least tworeference images. The registration is at least partially based on thedetermined common frame of reference and on the data indicative ofspatial relationships between the at least two landmark subsurfacefeatures of a mammalian body part. The data includes data indicative ofan edge content overlap between an edge content of a field of view of afirst reference image of the at least two reference images and an edgecontent of field of view of a second reference image of the at least tworeference images. The operation 3933 includes registering a spatialrelationship of the respective landmark subsurface feature of themammalian body part included in each reference image of the at least tworeference images, the registration is at least partially based on thedetermined common frame of reference and on the data indicative of arespective spatial relationship among each respective landmarksubsurface feature of the at least two reference images. In anembodiment, the storage operation 3940 may include at least oneadditional embodiment. The at least one additional embodiment mayinclude an operation 3941 or an operation 3942. The operation 3941includes maintaining in a computer-readable media informational datacorresponding to the spatial relationship of the respective landmarksubsurface feature of the mammalian body part included in each referenceimage of the at least two reference images. The operation 3942 includesmaintaining in a computer-readable media (i) informational datacorresponding to the registration of the respective landmark subsurfacefeature of the mammalian body part included in each reference image ofthe at least two reference images, and (ii) informational datacorresponding to the subsurface feature atlas of the mammalian bodypart.

FIG. 83 illustrates an alternative embodiment of the operational flow3900. In an embodiment, the operational flow may include at least oneadditional embodiment 3960. The at least one additional embodiment 3960may include an operation 3961, an operation 3962, an operation 3963, anoperation 3964, or an operation 3965. The operation 3961 includesoutputting a signal usable in displaying a human-perceivable indicationof the registration of the respective landmark subsurface feature of themammalian body part included in each reference image of the at least tworeference images. The operation 3962 includes outputting theinformational data. The operation 3963 includes transforming theinformational data corresponding to the registration of the respectivelandmark subsurface feature of the mammalian body part included in eachreference image of the at least two reference images into a particularvisual depiction of the spatial relationship of the respective landmarksubsurface feature of the mammalian body part included in each referenceimage of the at least two reference images. The operation 3964 includestransforming the informational data corresponding to the registration ofthe respective landmark subsurface feature of the mammalian body partincluded in each reference image of the at least two reference imagesinto a particular visual representation of the relative spatialrelationships of the respective landmark subsurface feature of themammalian body part included in each reference image of the at least tworeference images. The operation 3965 includes providing a notificationthat is at least partially based on the informational data to at leastone of a human, computer, or system.

FIG. 84 illustrates an example computer program product 4000. Thecomputer program product includes a computer-readable medium 4010bearing program instructions 4020. The program instructions, whenexecuted by a processor of a computing device, cause the computingdevice to perform a process. The process includes receiving at least tworeference images. Each reference image of the at least two referenceimages includes a respective landmark subsurface feature of a mammalianbody part. The process includes receiving data indicative of arespective spatial relationship among each respective landmarksubsurface feature of the at least two reference images. The processincludes determining a common frame of reference at least partiallybased on a landmark subsurface feature of the mammalian body partincluded in a reference image of the at least two reference images. Theprocess includes registering the respective landmark subsurface featureof the mammalian body part included in each reference image of the atleast two reference images. The registration is at least partially basedon the determined common frame of reference and on the data indicativeof a respective spatial relationship among each respective landmarksubsurface feature of the at least two reference images. The processincludes storing in another computer-readable medium operably coupledwith the processor informational data corresponding to the registrationof the respective landmark subsurface feature of the mammalian body partincluded in each reference image of the at least two reference images.

In an embodiment, the computer-readable media 4010 includes a tangiblecomputer-readable media 4012. In an embodiment, the computer-readablemedia includes a communications media 4014.

FIG. 85 illustrates an alternative embodiment of the computer programproduct 4000 of FIG. 84. In an embodiment, the program instructions 4020which, when executed by a processor of a computing device, cause thecomputing device to perform at least one additional process. The atleast one additional process may include a process 4022, a process 4024,a process 4026, or a process 4028. In an embodiment, the process furtherincludes 4022 outputting the informational data. In an embodiment, theprocess further includes 4024 outputting a signal usable in displaying ahuman-perceivable indication of the registration of the respectivelandmark subsurface feature of the mammalian body part included in eachreference image of the at least two reference images. In an embodiment,the process further includes 4026 transforming the informational datainto a particular visual depiction of the spatial relationship of therespective landmark subsurface feature of the mammalian body partincluded in each reference image of the at least two reference images.In an embodiment, the process further includes 4028 providing anotification that is at least partially based on the informational datato at least one of a human, computer, or system.

FIG. 86 illustrates an example system 4100. The system includes means4110 for receiving at least two reference images. Each reference imageof the at least two reference images includes a respective landmarksubsurface feature of a mammalian body part. The system includes means4120 for receiving data indicative of a respective spatial relationshipamong each respective landmark subsurface feature of the at least tworeference images. The system includes means 4130 for determining acommon frame of reference that is at least partially based on a landmarksubsurface feature of the mammalian body part included in a referenceimage of the at least two reference images. The system includes means4140 for registering the respective landmark subsurface feature of themammalian body part included in each reference image of the at least tworeference images. The registration is at least partially based on thedetermined common frame of reference and on the data indicative ofspatial relationships between the at least two landmark subsurfacefeatures of a mammalian body part. The system includes means 4150 forpersistently maintaining informational data corresponding to theregistration the respective landmark subsurface feature of the mammalianbody part included in each reference image of the at least two referenceimages.

Returning to FIG. 80, FIG. 80 illustrates an alternative embodiment ofthe system 3820. In the alternative embodiment of the system, the systemincludes the coordinate analysis circuit 3824, the registration circuit3826, and the computer-readable media 235. In the alternative embodimentof the system, the coordinate analysis circuit 3824 is configured todetermine a common frame of reference that is at least partially basedon a landmark subsurface feature of a mammalian body part included in areference image of at least two reference images. Each reference imageof the at least two reference images includes a respective landmarksubsurface feature of a mammalian body part. In the alternativeembodiment of the system, the registration circuit 3826 is configured toregister the respective landmark subsurface feature of the mammalianbody part included in each reference image of the at least two referenceimages. The registration is at least partially based on the determinedcommon frame of reference. In the alternative embodiment of the system,the computer-readable media 235 is configured to maintain informationaldata corresponding to the registration of the respective landmarksubsurface feature of the mammalian body part included in each referenceimage of the at least two reference images.

In an embodiment of the alternative embodiment of the system 3820, thecoordinate analysis circuit 3824 is configured to determine a commonframe of reference at least partially based on a landmark subsurfacefeature of a cavity or lumen of a mammalian body part included in areference image of at least two reference images. Each reference imageof the at least two reference images includes a respective landmarksubsurface feature of the cavity or lumen of a mammalian body part. Inan alternative embodiment, the registration circuit 3826 is configuredto register the respective landmark subsurface feature of the mammalianbody part included in each reference image of the at least two referenceimages. The registration is at least partially based on the determinedcommon frame of reference and on data indicative of a spatialrelationship among each respective landmark subsurface feature of the atleast two reference images.

In an embodiment of the alternative embodiment of the system 3820, theatlas generation circuit 3828 is configured generate a subsurfacefeature atlas of the mammalian body part. The subsurface feature atlasincludes a spatial relationship of the respective landmark subsurfacefeature of the mammalian body part included in each reference image ofthe at least two reference images. The subsurface feature atlas is atleast partially based on the registration of the respective landmarksubsurface feature of the mammalian body part included in each referenceimage of the at least two reference images. In an alternative embodimentof the alternative embodiment of the system, the computer-readable media235 is configured to maintain (i) informational data corresponding tothe registration of the respective landmark subsurface feature of themammalian body part included in each reference image of the at least tworeference images and (ii) informational data corresponding to thesubsurface feature atlas of the mammalian body part.

FIG. 87 illustrates an example operational flow 4100. The operationalflow includes a start operation. The operational flow includes areference operation 4110 that includes determining a common frame ofreference that is at least partially based on a landmark subsurfacefeature of a mammalian body part included in a reference image of atleast two reference images. Each reference image of the at least tworeference images includes a respective landmark subsurface feature of amammalian body part. In an embodiment, the reference operation may beimplemented using the coordinate analysis circuit 3824 described inconjunction with FIG. 80. The operational flow includes a registrationoperation 4120 that includes registering the respective landmarksubsurface feature of the mammalian body part included in each referenceimage of the at least two reference images, the registration is at leastpartially based on the determined common frame of reference. In anembodiment, the registration operation may be implemented using theregistration circuit 3826 described in conjunction with FIG. 80. Theoperational flow includes a storage operation 4130 that includesmaintaining in a computer-readable media informational datacorresponding to the registration of the respective landmark subsurfacefeature of the mammalian body part included in each reference image ofthe at least two reference images. In an embodiment, the storageoperation may be implemented using the computer-readable media 235described in conjunction with FIG. 80. The operational flow includes anend operation.

In an alternative embodiment, the operational flow 4100 includes amapping operation 4140 that includes generating a subsurface featureatlas of the mammalian body part. The subsurface feature atlas includesa spatial relationship of the respective landmark subsurface feature ofthe mammalian body part included in each reference image of the at leasttwo reference images. The subsurface feature atlas is at least partiallybased on the registration the respective landmark subsurface feature ofthe mammalian body part included in each reference image of the at leasttwo reference images.

FIG. 88 illustrates an alternative embodiment of the operational flow4100. In an embodiment, reference operation 4110 may include at leastone additional embodiment, such as an operation 4111. The operation 4111includes determining a common frame of reference that is at leastpartially based on a landmark subsurface feature of a cavity or lumen ofa mammalian body part included in a reference image of at least tworeference images. Each reference image of the at least two referenceimages includes a respective landmark subsurface feature of the cavityor lumen of a mammalian body part. In an embodiment, the registrationoperation 4120 may include at least one additional embodiment. The atleast one additional embodiment may include an operation 4121 or anoperation 4122. The operation 4121 includes registering the respectivelandmark subsurface feature of the mammalian body part included in eachreference image of the at least two reference images. The registrationis at least partially based on the determined common frame of referenceand on data indicative of a spatial relationship among each respectivelandmark subsurface feature of the at least two reference images. Theoperation 4122 includes registering a spatial relationship of therespective landmark subsurface feature of the mammalian body partincluded in each reference image of the at least two reference images.The registration is at least partially based on the determined commonframe of reference. In an embodiment, the storage operation 4130 mayinclude at least one additional embodiment, such as the operation 4131.The operation 4131 includes maintaining in a computer-readable mediainformational data corresponding to (i) the registration of the at leasttwo landmark subsurface features included in the reference image and(ii) the generated subsurface feature atlas of the mammalian body part.

FIG. 89 illustrates a computer program product 4200. The computerprogram product includes a computer-readable medium 4210 bearing programinstructions 4220. The program instructions, when executed by aprocessor of a computing device, cause the computing device to perform aprocess. The process includes determining a common frame of referencethat is at least partially based on a landmark subsurface feature of amammalian body part included in a reference image of at least tworeference images. Each reference image of the at least two referenceimages includes a respective landmark subsurface feature of a mammalianbody part. The process includes registering the respective landmarksubsurface feature of the mammalian body part included in each referenceimage of the at least two reference images. The registration is at leastpartially based on the determined common frame of reference. The processincludes storing in another computer-readable medium operably coupledwith the processor informational data corresponding to the registrationof the respective landmark subsurface feature of the mammalian body partincluded in each reference image of the at least two reference images.

In an embodiment, the registering process includes 4222 registering therespective landmark subsurface feature of the mammalian body partincluded in each reference image of the at least two reference images.The registration is at least partially based on the determined commonframe of reference and on data indicative of a spatial relationshipamong each respective landmark subsurface feature of the at least tworeference images. In an embodiment, the process further includes 4224generating a subsurface feature atlas of the mammalian body part. Thesubsurface feature atlas includes a spatial relationship of therespective landmark subsurface feature of the mammalian body partincluded in each reference image of the at least two reference images.The subsurface feature atlas is at least partially based on theregistration of the respective landmark subsurface feature of themammalian body part included in each reference image of the at least tworeference images.

In an embodiment, the computer-readable media 4210 includes a tangiblecomputer-readable media 4212. In an embodiment, the computer-readablemedia includes a communications media 4214.

FIG. 90 illustrates an example system 4300. The system includes means4310 for determining a common frame of reference that is at leastpartially based on a landmark subsurface feature of a mammalian bodypart included in a reference image of at least two reference images.Each reference image of the at least two reference images includes arespective landmark subsurface feature of a mammalian body part. Thesystem includes means 4320 for registering the respective landmarksubsurface feature of the mammalian body part included in each referenceimage of the at least two reference images. The registration is at leastpartially based on the determined common frame of reference. The systemincludes means 4330 for persistently maintaining computer-readableinformational data corresponding to the registration of the respectivelandmark subsurface feature of the mammalian body part included in eachreference image of the at least two reference images.

FIG. 91 illustrates an example environment 4400. The environmentincludes the mammalian body part 210 of the mammal 205, and a system4420. The environment includes a body-insertable device 4480 moveable4488 through the cavity or lumen 211 of the mammalian body part 210. Thebody insertable device includes a distal end portion 4483. The distalend portion may include a digital image acquisition device 4481, such asa digital camera. The distal end portion 4482 may include an activeelement, such as an effector, scalpel, or an ablation element. Thesystem includes a receiver circuit 4422. The receiver circuit isconfigured to receive a first reference image that includes an objectivelandmark subsurface feature of a mammalian body part. The objectivelandmark subsurface feature has a first spatial relationship to adestination region of interest of the mammalian body part. For example,the objective landmark subsurface feature or the destination region ofinterest may be provided by a human or a machine, a feature choosingcircuit, or from an atlas. In an embodiment, for example, the objectivelandmark subsurface feature may be considered as a goal, a marker, orsomething that is being aimed-at or sought because once the objectivelandmark subsurface feature is located, the destination region ofinterest may be located by virtue of its first spatial relationship tothe objective landmark subsurface feature. In an embodiment, the firstreference image may have been acquired in an earlier colonoscopy, andmay depict a region of interest to which the health care provider wantsto return for a procedure or further examination. FIG. 92 illustrates analternative embodiment of the environment 4400 including additionaldetails of the mammalian body part 210 illustrated in FIG. 4. Forexample, the objective landmark subsurface feature may be the landmarksubsurface feature 216A having a first spatial relationship 217A to thedestination region of interest 214A of the mammalian body part 210illustrated in View 92B of FIG. 92. In another example, the objectivelandmark subsurface feature may be the landmark subsurface feature 216Bhaving a first spatial relationship 217B to the destination region ofinterest 214B of the mammalian body part 210 illustrated in View 92B ofFIG. 92.

Returning to FIG. 91, the receiver circuit 4422 is also configured toreceive a second reference image that includes a present-locationlandmark subsurface feature of the mammalian body part. Thepresent-location landmark subsurface feature has a second spatialrelationship to a distal end portion of a body-insertable device. View92B of FIG. 92 illustrates the body-insertable device 4480 deployed inthe cavity or lumen 211 of the mammalian body part 210. View 92B alsoillustrates an embodiment where the present-location landmark subsurfacefeature is landmark subsurface feature 216B having a second spatialrelationship 4815 to the operative portion, illustrated as the distalend portion 4483 of the body-insertable device deployed operationallyproximate to the mammalian body part. For example, the body insertabledevice may include an endoscope having an ablation tool 4482 at a distalend, and inserted in the mammalian body part by the health care providerto perform a procedure. For example, operationally proximate may includewhere the ablation tool at a distal end of an endoscope can reach andablate at least a portion of the destination region of interest.

The system 4420 includes a feature matching circuit 4424 configured todetermine a substantial correspondence between the present-locationlandmark subsurface feature and the objective landmark subsurfacefeature. For example, substantial correspondence may be determined usinga pattern matching technique. For example, if the objective landmarksubsurface feature is the landmark subsurface feature 216A having aspatial relationship 217A to the region of interest 214A of themammalian body part 210 illustrated in illustrated in View 92B of FIG.92, and if the present-location landmark subsurface feature is thelandmark subsurface feature 216B having the spatial relationship 4815 tothe operative portion, illustrated as the distal end portion 4483 of thebody-insertable device, the feature matching circuit will determine nosubstantial correspondence. In such an example, a determined “nosubstantial correspondence” indicates the health care provider does nothave the operative portion of the body-insertable device deployedoperationally proximate to the region of interest. In another example,if the objective landmark subsurface feature is the landmark subsurfacefeature 216B having the spatial relationship 217B to the region ofinterest 214B of the mammalian body part 210 illustrated in FIG. 92, andif the present-location landmark subsurface feature is the landmarksubsurface feature 216B having a spatial relationship 4815 to theoperative portion, illustrated as the distal end portion 4483 of thebody-insertable device, the feature matching circuit will determine asubstantial correspondence. In such an example, a determined“substantial correspondence” indicates the health care provider has theoperative portion of the body-insertable device deployed operationallyproximate to the region of interest.

Continuing with FIG. 91, the system 4420 includes a proximity indicatorcircuit 4426 configured to generate informational data indicative of anoperational proximity of the distal end portion of the body-insertabledevice 4480 to the destination region of interest. The informationaldata indicative of operational proximity is at least partially based onthe determined substantial correspondence.

In an embodiment of the system 4420, the first reference image includesan objective landmark subsurface feature of a mammalian body part. Theobjective landmark subsurface feature has a first spatial relationshipto a destination region of interest of the mammalian body part, and theobjective landmark subsurface feature is distinguishable from otherlandmark subsurface features of the mammalian body part. For example,the objective landmark subsurface feature may be detectable by afluoroscope, ultrasound, or x-ray and machine-distinguishable from otherlandmark subsurface features of the mammalian body part.

In an embodiment, first reference image includes an objective landmarksubsurface feature of a mammalian body part. The objective landmarksubsurface feature has an indicated, determinable, estimable, orinferable first spatial relationship to a destination region of interestof the mammalian body part. In an embodiment, the first reference imageincludes an objective landmark subsurface feature of a mammalian bodypart. The objective landmark subsurface feature has a spatialrelationship to a region of interest of a cavity or lumen of themammalian body part. In an embodiment, the first reference imageincludes an objective landmark subsurface feature of a mammalian bodypart. The objective landmark subsurface feature has a first spatialrelationship to a region of interest of a surface of a cavity or lumenof the mammalian body part. In an embodiment, the first reference imageincludes a first reference image acquired by an ex vivo device andincludes an objective landmark subsurface feature of a mammalian bodypart. The objective landmark subsurface feature has a first spatialrelationship to a region of interest of the mammalian body part. In anembodiment, the first reference image includes a first reference imageacquired by the body-insertable device and includes an objectivelandmark subsurface feature of a mammalian body part. The objectivelandmark subsurface feature has a first spatial relationship to a regionof interest of the mammalian body part.

In an embodiment of the system 4420, the second reference image includesa present-location landmark subsurface feature of the mammalian bodypart. The present-location landmark subsurface feature having a secondspatial relationship to a distal end of a body-insertable devicedeployed operationally proximate to the mammalian body part. In anembodiment, the second reference image includes a present-locationlandmark subsurface feature of the mammalian body part. Thepresent-location landmark subsurface feature having a second spatialrelationship to an operative end of a body-insertable device deployedoperationally proximate to the mammalian body part. In an embodiment,the second reference image includes a present-location landmarksubsurface feature of the mammalian body part. The present-locationlandmark subsurface feature having a second spatial relationship to anoperative and movable distal end portion of a body-insertable devicedeployed operationally proximate to the mammalian body part. In anembodiment, the second reference image includes a present-locationlandmark subsurface feature of the mammalian body part. Thepresent-location landmark subsurface feature having a second spatialrelationship to a distal end portion of the body-insertable devicedeployed in a cavity or lumen of the mammalian body part. In anembodiment, the second reference image includes a second reference imageacquired by a body-insertable device and includes a present-locationlandmark subsurface feature of the mammalian body part. Thepresent-location landmark subsurface feature has a second spatialrelationship to a portion of the body-insertable device deployedoperationally proximate to the mammalian body part. In an embodiment,the second reference image includes a second reference image acquired byan ex vivo device and includes a present-location landmark subsurfacefeature of the mammalian body part. The present-location landmarksubsurface feature has a second spatial relationship to a portion of abody-insertable device deployed operationally proximate to the mammalianbody part.

In an embodiment, the feature matching circuit 4424 is configured todetermine at least one of a structural, pattern, orientation, physicalcharacteristic, or identification correspondence between thepresent-location landmark subsurface feature and the objective landmarksubsurface feature. In an embodiment, the feature matching circuit isconfigured to determine a match between the present-location landmarksubsurface feature and the objective landmark subsurface feature.

In an embodiment, the proximity indicator circuit 4426 is configured togenerate informational data indicative of an operational proximity ofthe distal end portion of the body-insertable device to the destinationregion of interest. The informational data is at least partially basedon a scale suitable for operational use of the body-insertable devicewith respect to the destination region of interest. The informationaldata is at least partially based on the determined substantialcorrespondence between the present-location landmark subsurface featureand the objective landmark subsurface feature. For example, theoperational proximity may be indicated based upon a scale of inches,centimeters, or millimeters suitable for an operational use of thebody-insertable device relative to the region of interest. In anembodiment, the proximity indicator circuit is configured to generateinformational data indicative of a distance of less than fourcentimeters between the distal end portion of the body-insertable deviceand the destination region of interest. In an embodiment, the proximityindicator circuit is configured to generate informational dataindicative of a distance of less than two centimeters between the distalend portion of the body-insertable device and the destination region ofinterest. In an embodiment, the proximity indicator circuit isconfigured to generate informational data indicative of a distance ofless than one centimeter between the distal end distal end portion ofthe body-insertable device and the destination region of interest.

In an embodiment, the proximity indicator circuit 4426 is to generateinformational data indicative of a proximity distance of the distal endportion of the body-insertable device to the destination region ofinterest. The informational data is at least partially based on adetermined substantial correspondence between the landmark subsurfacefeature of the mammalian body part and the present-location subsurfacefeature of the mammalian body part. The indicated distance includes adistance within a user-selected range. For example, a user-selectedrange may be a range of less than 4 cm, or less than 2 cm. In anembodiment, the proximity indicator circuit is configured to generateinformational data indicative of an absence of a proximity between thedistal end portion of the body-insertable device and the destinationregion of interest. The informational data is at least partially basedon the determined substantial correspondence between thepresent-location landmark subsurface feature and the objective landmarksubsurface feature. In an embodiment, the proximity indicator circuit isconfigured to output a signal usable in displaying a human-perceivableindication of an operational proximity of the distal end portion of thebody-insertable device to the destination region of interest. The signalis at least partially based on the determined substantial correspondencebetween the present-location landmark subsurface feature and theobjective landmark subsurface feature. In an embodiment, the proximityindicator circuit is configured to generate informational dataindicative of an operational proximity of the distal end portion of thebody-insertable device to the destination region of interest in responseto the determined substantial correspondence between thepresent-location landmark subsurface feature and the objective landmarksubsurface feature; otherwise, to generate informational data indicativeof an absence of an operational proximity of the distal end portion ofthe body-insertable device to the destination region of interest.

In an embodiment, the system 4420 includes an event data circuit 4428configured to generate operational-proximity event informational dataindicative of an operational proximity of the distal end portion of thebody-insertable device to the destination region of interest. Anoccurrence of an operational-proximity event is at least partially basedon the informational data indicative of an operational proximity of thedistal end portion of the body-insertable device to the destinationregion of interest.

In an embodiment, the system includes a feature-choosing circuit 4436configured to select the objective landmark subsurface feature of themammalian body part. In an embodiment, the feature-choosing circuit isconfigured to select the objective landmark subsurface feature of themammalian body part in response to a human user or a machine initiatedinput. In an embodiment, the feature-choosing circuit is configured toselect the objective landmark subsurface feature of the mammalian bodypart from informational data indicating the spatial relationship of theregion of interest relative to the objective landmark subsurfacefeature.

In an embodiment, the system 4420 includes the computer-readable media235 configured to maintain the informational data corresponding to theoperational proximity of the distal end portion of the body-insertabledevice to the destination region of interest. In an embodiment, thecomputer readable-media is configured to maintain (i) the informationaldata corresponding to the operational proximity of the distal endportion of the body-insertable device to the destination region ofinterest and (ii) the operational-proximity event informational data.

In an embodiment, the system includes a communication circuit 4442configured to output the informational data operational proximity of thedistal end portion of the body-insertable device to the destinationregion of interest. In an embodiment, the communication circuit isconfigured to output (i) the informational data corresponding to theoperational proximity of the distal end portion of the body-insertabledevice to the destination region of interest and (ii) theoperational-proximity event informational data. In an embodiment, thesystem includes the communication circuit configured to provide anotification that is at least partially based on the informational datato at least one of a human, computer, or system. In an embodiment, thesystem includes the communication device 292 configured to display ahuman-perceivable depiction of the informational data. In an embodiment,the human-perceivable depiction includes an audio or visualhuman-perceivable depiction of the operational proximity of the portionof the body-insertable device to the region of interest.

FIG. 93 illustrates an example operational flow 4500. The operationalflow includes a start operation. The operational flow includes a firstreception operation 4510. The first reception operation includesreceiving a first reference image that includes an objective landmarksubsurface feature of a mammalian body part. The objective landmarksubsurface feature has a first spatial relationship to a destinationregion of interest of the mammalian body part. A second receptionoperation 4520 includes receiving a second reference image that includesa present-location landmark subsurface feature of the mammalian bodypart. The present-location landmark subsurface feature has a secondspatial relationship to a distal end portion of a body-insertabledevice. In an embodiment, the first reception operation or the secondreception operation may be implemented using the receiver circuit 4422described in conjunction with FIG. 91. A matching operation 4530includes determining a substantial correspondence between thepresent-location landmark subsurface feature and the objective landmarksubsurface feature. In an embodiment, correspondence may include apattern matching, an orientation, or a spatial relationshipcorrespondence. In an embodiment, the matching operation may beimplemented using the feature matching circuit 4424 described inconjunction with FIG. 91. A nearness operation 4540 includes generatinginformational data indicative of an operational proximity of the distalend portion of the body-insertable device to the destination region ofinterest. The informational data indicative of operational proximity isat least partially based on the determined substantial correspondence.In an embodiment, the nearness operation may be implemented using theproximity indicator circuit 4426 described in conjunction with FIG. 91.The operational flow includes an end operation.

In an embodiment, the operational flow 4500 may include at least oneadditional embodiment, such as a storage operation 4550. The storageoperation includes maintaining the informational data in acomputer-readable media. In an embodiment, the storage operation may beimplemented using the computer-readable media 235 described inconjunction with FIG. 91.

FIG. 94 illustrates an alternative embodiment of the operational flow4500 of FIG. 93. In an embodiment, the first reception operation 4510may include at least one additional embodiment. The at least oneadditional embodiment may include an operation 4511 or an operation4512. The operation 4511 includes receiving a first reference image thatincludes an objective landmark subsurface feature of a cavity or lumenof a mammalian body part. The operation 4512 includes receiving a firstreference image that includes an objective landmark subsurface featureof a surface of a cavity or lumen of a mammalian body part. In anembodiment, the second reception operation 4520 may include at least oneadditional embodiment. The at least one additional embodiment mayinclude an operation 4521. The operation 4521 includes receiving asecond reference image that includes a present-location landmarksubsurface feature of the mammalian body part. The present-locationlandmark subsurface feature has a second spatial relationship to adistal end portion of a body-insertable device deployed operationallyproximate to the mammalian body part.

FIG. 95 illustrates an alternative embodiment of the operational flow4500 of FIG. 93. In an embodiment, the matching operation 4530 mayinclude at least one additional embodiment. The at least one additionalembodiment may include an operation 4531 or an operation 4532. Theoperation 4531 includes generating informational data indicative of anoperational proximity of the distal end portion of the body-insertabledevice to the destination region of interest. The informational data isat least partially based on a scale suitable for medical use of thebody-insertable device with respect to the destination region ofinterest. The informational data is further at least partially based onthe determined substantial correspondence between the present-locationlandmark subsurface feature and the objective landmark subsurfacefeature The operation 4532 includes generating informational dataindicative of a proximity distance of less than four centimeters betweenthe distal end portion of the body-insertable device and the destinationregion of interest. The informational data is at least partially basedon the determined substantial correspondence between thepresent-location landmark subsurface feature and the objective landmarksubsurface feature.

FIG. 96 illustrates an alternative embodiment of the operational flow4500 of FIG. 93. In an embodiment, the operational flow may include atleast one additional embodiment. The at least one additional embodimentmay include an operation 4561, an operation 4562, an operation 4563, anoperation 4564, or an operation 4565. The operation 4561 includesoutputting the informational data. The operation 4562 includesoutputting a signal useable in displaying a human-perceivable indicationof the operational proximity of the distal end portion of thebody-insertable device to the destination region of interest. Theoperation 4563 includes transforming the informational data into aparticular visual depiction of the operational proximity of the distalend portion of the body-insertable device to the destination region ofinterest. The operation 4564 includes providing a notification that isat least partially based on the informational data to at least one of ahuman, computer, or system. The operation 4565 includes displaying ahuman-perceivable indication of the operational proximity of the distalend portion of the body-insertable device to the destination region ofinterest, the displaying is at least partially based on theinformational data.

FIG. 97 illustrates a computer program product 4600. The computerprogram product includes a computer-readable computer storage medium4610 bearing program instructions 4620. The program instructions, whenexecuted by a processor of a computing device, cause the computingdevice to perform a process. The process includes receiving a firstreference image that includes an objective landmark subsurface featureof a mammalian body part. The objective landmark subsurface feature hasa first spatial relationship to a destination region of interest of themammalian body part. The process includes receiving a second referenceimage that includes a present-location landmark subsurface feature ofthe mammalian body part. The present-location landmark subsurfacefeature has a second spatial relationship to a distal end portion of abody-insertable device. The process includes determining a substantialcorrespondence between the present-location landmark subsurface featureand the objective landmark subsurface feature. The process includesgenerating informational data indicative of an operational proximity ofthe distal end portion of the body-insertable device to the destinationregion of interest. The informational data indicative of operationalproximity is at least partially based on the determined substantialcorrespondence between the present-location landmark subsurface featureand the objective landmark subsurface feature. The process includesoutputting the informational data.

In an embodiment, the computer-readable media 4610 includes a tangiblecomputer-readable media 4612. In an embodiment, the computer-readablemedia includes a communications medium 4614.

FIG. 98 illustrates an alternative embodiment of the computer programproduct 4600 of FIG. 97. In an embodiment, the outputting processincludes 4622 outputting a signal useable in displaying ahuman-perceivable indication of the operational proximity of the portionof the body-insertable device to the region of interest. The signal isat least partially based on the informational data. In an embodiment,the process further includes 4624 transforming the informational datainto a particular visual depiction of the operational proximity of thedistal end portion of the body-insertable device to the destinationregion of interest. In an embodiment, the process further includes 4626providing a notification that is at least partially based on theinformational data to at least one of a human, computer, or system. Inan embodiment, the process further includes 4628 storing in anothercomputer-readable medium operably coupled with the processor theinformational data.

FIG. 99 illustrates an example system 4700. The system includes means4710 for receiving a first reference image that includes an objectivelandmark subsurface feature of a mammalian body part. The objectivelandmark subsurface feature has a first spatial relationship to adestination region of interest of the mammalian body part. The systemincludes means 4720 for receiving a second reference image that includesa present-location landmark subsurface feature of the mammalian bodypart. The present-location landmark subsurface feature has a secondspatial relationship to a distal end portion of a body-insertabledevice. The system includes means 4730 for determining a substantialcorrespondence between the present-location landmark subsurface featureand the objective landmark subsurface feature. The system includes means4740 for generating informational data indicative of an operationalproximity of the distal end portion of the body-insertable device to thedestination region of interest. The informational data indicative ofoperational proximity is at least partially based on the determinedsubstantial correspondence between the present-location landmarksubsurface feature and the objective landmark subsurface feature. Thesystem includes means 4750 for outputting informational data. In anembodiment, the system includes means 4760 for persistently maintainingthe informational data in a computer-readable form.

Returning to FIG. 91, FIG. 91 illustrates an alternative embodiment ofan example system 4422. In the alternative embodiment of the system, thefeature matching circuit 4424 is configured to determine a substantialcorrespondence between a present-location landmark subsurface feature ofa mammalian body part and an objective landmark subsurface feature ofthe mammalian body part. The objective landmark subsurface feature has afirst spatial relationship to a destination region of interest of amammalian body part, and the present-location landmark subsurfacefeature has a second spatial relationship to a distal end portion of abody-insertable device. In the alternative embodiment of the system, theproximity indicator circuit 4426 is configured to generate informationaldata indicative of an operational proximity of the distal end portion ofthe body-insertable device to the destination region of interest. Thesignal is indicative of operational proximity is at least partiallybased on the determined substantial correspondence between thepresent-location landmark subsurface feature and the objective landmarksubsurface feature. In the alternative embodiment of the system, thecommunication circuit 4442 is configured to provide a notification thatis at least partially based on the informational data to at least one ofa human, computer, or system.

In an embodiment of the alternative embodiment of the system 4422, thefeature matching circuit 4424 is configured to determine a substantialcorrespondence between a present-location landmark subsurface feature ofa mammalian body part and an objective landmark subsurface feature ofthe mammalian body part. The objective landmark subsurface feature has afirst spatial relationship to a destination region of interest of amammalian body part, and the present-location landmark subsurfacefeature has a second spatial relationship to a distal end portion of abody-insertable device deployed operationally proximate to the mammalianbody part.

FIG. 100 illustrates an example operational flow 5000 implemented in acomputing device. The method includes a start operation. A matchingoperation 5010 includes determining a substantial correspondence betweena present-location landmark subsurface feature of a mammalian body partand an objective landmark subsurface feature of the mammalian body part.The objective landmark subsurface feature has a first spatialrelationship to a destination region of interest of a mammalian bodypart, and the present-location landmark subsurface feature has a secondspatial relationship to a distal end portion of a body-insertabledevice. In an embodiment, the matching operation may be implementedusing the feature matching circuit 4424 described in conjunction withFIG. 91. A proximity operation 5020 includes determining an operationalproximity of the distal end portion of the body-insertable device to thedestination region of interest. The determination of operationalproximity is at least partially based on the determined substantialcorrespondence between the present-location landmark subsurface featureand the objective landmark subsurface feature. In an embodiment, theproximity operation may be implemented using the proximity indicatorcircuit 4426 described in conjunction with FIG. 91. A communicationoperation 5030 includes outputting informational data corresponding tothe determined operational proximity of the distal end portion of thebody-insertable device to the destination region of interest. In anembodiment, the communication operation may be implemented using thecommunications circuit 4442 described in conjunction with FIG. 91. Theoperational flow includes an end operation.

In an embodiment, the mammalian body part includes a cavity or lumen ofa mammalian body part. In an embodiment, the mammalian body partincludes a surface of a cavity or lumen of a mammalian body part.

FIG. 101 illustrates an alternative embodiment of the operational flow5000 of FIG. 100. In an embodiment, the matching operation 5010 mayinclude at least one additional embodiment, such as the operation 5011.The operation 5011 includes determining a substantial correspondencebetween a present-location landmark subsurface feature of a mammalianbody part and an objective landmark subsurface feature of the mammalianbody part. The objective landmark subsurface feature has a first spatialrelationship to a destination region of interest of a mammalian bodypart, and the present-location landmark subsurface feature has a secondspatial relationship to a distal end portion of a body-insertable devicedeployed operationally proximate to the mammalian body part. In anembodiment, the proximity operation 5020 may include at least oneadditional embodiment, such as the operation 5021. The operation 5021includes a proximity distance between the distal end portion of thebody-insertable device and the destination region of interest. Thedetermination of a proximity distance is at least partially based on thedetermined substantial correspondence between the present-locationlandmark subsurface feature and the objective landmark subsurfacefeature.

FIG. 102 illustrates an example environment 5100. The environmentincludes the mammalian body part 210 of the mammal 205, thebody-insertable device 4480, and a system 5120. The system 5120 includesa receiver circuit 5122 configured to receive a first reference imagethat includes an objective landmark subsurface feature of a mammalianbody part. The objective landmark subsurface feature has a first spatialrelationship to a destination region of interest of the mammalian bodypart. The receiver circuit is also configured to receive a secondreference image that includes a present-location landmark subsurfacefeature of the mammalian body part. The present-location landmarksubsurface feature has a second spatial relationship to a distal endportion of a body-insertable device deployed operationally proximate tothe mammalian body part.

The system 5120 includes a feature matching circuit 5124 configured todetermine a substantial correspondence between the objective landmarksubsurface feature and a first atlas subsurface feature included in asubsurface feature atlas of the mammalian body part. In an embodiment,the subsurface feature atlas may have been prepared in a mannerdescribed in this document. In an embodiment, the subsurface featureatlas may have been prepared for an individual patient whose mammalianbody part 210 is the subject of a procedure implemented in theenvironments 5100 and 5200. In an embodiment, the subsurface featureatlas may have been generally prepared for a mammal whose mammalian bodypart 210 is the subject of a procedure implemented in the environments5100 and 5200. In an embodiment, the subsurface feature atlas may be agenerally published atlas of the body part. In an embodiment, thesubsurface feature atlas may be in electronic form and locallyavailable, or may be accessed via a network. The feature matchingcircuit 5124 is also configured to determine a substantialcorrespondence between the present-location landmark subsurface featureand a second atlas subsurface feature included in the subsurface featureatlas of the mammalian body part. The subsurface feature atlas includesat least two registered subsurface features of the mammalian body part.The subsurface feature atlas includes the first atlas subsurface featureand the second atlas subsurface feature. The registration of thesubsurface feature atlas includes an indication of a third spatialrelationship between the first atlas subsurface feature and the secondatlas subsurface feature.

The system 5120 includes a location analysis circuit 5126 configured todetermine a fourth spatial relationship between the destination regionof interest and the distal end portion of the body-insertable devicedeployed operationally proximate to the mammalian body part. Thedetermined fourth spatial relationship is at least partially based onthe third spatial relationship. For example, in an embodiment, if thefirst atlas subsurface feature and the second atlas subsurface featureare substantially the same, then the fourth spatial relationshipdistance is expected to be minimal and the body-insertable device isoperationally proximate. For example, in an embodiment, if the firstatlas subsurface feature and the second atlas subsurface feature are notsubstantially the same, then the fourth spatial relationship distance islikely more than minimal and the body-insertable device is notoperationally proximate to the region of interest. The system includesan indicator circuit 5128 configured to generate informational dataindicative of the determined fourth spatial relationship between thedestination region of interest and the distal end portion of thebody-insertable device. The informational data is at least partiallybased on the fourth spatial relationship between the destination regionof interest and the distal end portion of the body-insertable device.The system 5120 includes the computer-readable media 235 configured tomaintain the informational data.

An example of an operation of the system 5120 may be illustrated usingFIG. 103. FIG. 103 illustrates an environment 5200 in which the system5120 may be used to guide the body-insertable device 4480 into anoperational proximity to a region of interest 5214. FIG. 103 illustratesan embodiment of a subsurface feature atlas 5250 including registeredatlas subsurface features A through Z, illustrated as atlas subsurfacefeature 5252A, and atlas subsurface features 5252X through 5252Z. Thesubsurface feature atlas also indicates the registration of the atlassubsurface features. The registration is indicated by the respectivespatial relationships illustrated between the at least two atlassubsurface features. For example, the subsurface feature atlasillustrates a spatial relationship between an atlas subsurface feature5252X and the atlas subsurface feature 5252Z as spatial relationship5254XZ. In this example, the atlas subsurface feature 5252X may bedescribed as a first atlas subsurface feature and the atlas subsurfacefeature 5252Z may be described as a second atlas subsurface feature, andthe spatial relationship 5254XZ between them may be described as a thirdspatial relationship.

For example; in operation, the receiver circuit 5122 receives a firstreference image 5210 that includes an objective landmark subsurfacefeature 5212 of a mammalian body part 210. The objective landmarksubsurface feature has a first spatial relationship 5216 to adestination region of interest 5214 of the mammalian body part. Thereceiver circuit receives a second reference image 5220 that includes apresent-location landmark subsurface feature 5222 of the mammalian bodypart. The present-location landmark subsurface feature has a secondspatial relationship 5226 to the distal end portion 4483 of abody-insertable device 4480 deployed operationally proximate 4489 to themammalian body part.

Continuing with the example, the feature matching circuit 5124determines a substantial correspondence between the objective landmarksubsurface feature 5212 and the first atlas subsurface feature 5252Xincluded in the subsurface feature atlas 5250 of the mammalian body part210. The feature matching circuit also determines a substantialcorrespondence between the present-location landmark subsurface feature5222 and the second atlas subsurface feature 5252Z included in thesubsurface feature atlas of the mammalian body part. The locationanalysis circuit 5126 determines a fourth spatial relationship 5230between the destination region of interest 5214 and the distal endportion 4483 of the body-insertable device 4480 deployed operationallyproximate 4489 to the mammalian body part 210. The determined fourthspatial relationship is at least partially based on the third spatialrelationship 5254XZ between the first atlas subsurface feature 5252X andthe second atlas subsurface feature 5252Z as indicated by the subsurfacefeature atlas. The indicator circuit 5128 generates informational dataindicative of the determined fourth spatial relationship between thedestination region of interest and the distal end portion of thebody-insertable device. The informational data is at least partiallybased on the fourth spatial relationship between the destination regionof interest and the distal end portion of the body-insertable device.The computer-readable media 235 maintains the informational data.

In an embodiment of the system 5120, first digital image includes areference landmark subsurface feature of a mammalian body part. Thereference landmark subsurface feature has a first spatial relationshipto a region of interest of the mammalian body part. The referencelandmark subsurface feature is distinguishable from other landmarksubsurface features of the mammalian body part.

In an embodiment, the first digital image includes a reference landmarksubsurface feature of a mammalian body part. The reference landmarksubsurface feature has an indicated, determinable, estimable, orinferable first spatial relationship to a region of interest of themammalian body part.

In an embodiment, the first reference image includes an objectivelandmark subsurface feature of a mammalian body part. The objectivelandmark subsurface feature has a first spatial relationship to adestination region of interest of the mammalian body part and isdistinguishable over other landmark subsurface features of the mammalianbody part. In an embodiment, the objective landmark subsurface featurehas an indicated, determinable, estimable, or inferable first spatialrelationship to a destination region of interest of the mammalian bodypart.

In an embodiment, the first reference image includes an objectivelandmark subsurface feature of a mammalian body part. The objectivelandmark subsurface feature has a first spatial relationship to adestination region of interest of a cavity or lumen of the mammalianbody part. In an embodiment, the objective landmark subsurface featurehas a first spatial relationship to a destination region of interest ofa surface of a cavity or lumen of the mammalian body part.

In an embodiment, the first reference image was acquired by an ex vivodevice, such as the ex vivo device 290, and includes an objectivelandmark subsurface feature of a mammalian body part. The objectivelandmark subsurface feature has a first spatial relationship to adestination region of interest of the mammalian body part. In anembodiment, first reference image was acquired by the body-insertabledevice 4480 and includes an objective landmark subsurface feature of amammalian body part.

In an embodiment, the first reference that includes an objectivelandmark subsurface feature of a mammalian body part. The objectivelandmark subsurface feature has a first spatial relationship to ahuman-user selected destination region of interest of the mammalian bodypart. In an embodiment, the objective landmark subsurface feature has afirst spatial relationship to a machine-selected destination region ofinterest of the mammalian body part.

In an embodiment, the second reference image includes a present-locationlandmark subsurface feature of the mammalian body part. Thepresent-location landmark subsurface feature has a second spatialrelationship to an effector carried by a distal end portion of abody-insertable device and deployed operationally proximate to themammalian body part. In an embodiment, the present-location landmarksubsurface feature has a second spatial relationship to an operative andmovable distal end portion of a body-insertable device deployedoperationally proximate to the mammalian body part. In an embodiment,the present-location landmark subsurface feature has a second spatialrelationship to a distal end portion of a body-insertable devicedeployed in a cavity or lumen of the mammalian body part.

In an embodiment, the second reference image was acquired by abody-insertable device and includes a present-location landmarksubsurface feature of the mammalian body part. The present-locationlandmark subsurface feature has a second spatial relationship to adistal end portion of the body-insertable device deployed operationallyproximate to the mammalian body part. In an embodiment, the secondreference image was acquired by an ex vivo device and includes apresent-location landmark subsurface feature of the mammalian body part.

In an embodiment, the feature matching circuit 5124 is configured todetermine at least one of a substantial structural, orientation,pattern, or physical characteristic correspondence between the objectivelandmark subsurface feature and a first atlas subsurface featureincluded in a subsurface feature atlas of the mammalian body part. Thefeature matching circuit is also configured to determine at least one ofa substantial structural, orientation, pattern, or physicalcharacteristic correspondence between the present-location landmarksubsurface feature and a second atlas subsurface feature included in thesubsurface feature atlas of the mammalian body part. In an embodiment,the feature matching circuit is configured to determine substantialmatch between the objective landmark subsurface feature and a firstatlas subsurface feature included in a subsurface feature atlas of themammalian body part. The feature matching circuit is also configured todetermine a substantial match between the present-location landmarksubsurface feature and a second atlas subsurface feature included in thesubsurface feature atlas of the mammalian body part.

In an embodiment, the location analysis circuit 5216 is configured todetermine a fourth spatial relationship between the destination regionof interest and the distal end portion of the body-insertable devicedeployed operationally proximate to the mammalian body part. The fourthspatial relationship is determined at least partially in response to:(i) a fifth spatial relationship between the objective landmarksubsurface feature and the present-location landmark subsurface feature(this determination is at least partially based on a spatialrelationship between the first atlas subsurface feature and the secondatlas subsurface feature as indicated by the subsurface feature atlas);(ii) the first spatial relationship between the destination region ofinterest and the objective landmark subsurface feature; and (iii) thesecond spatial relationship between the distal end portion of thebody-insertable device and the present-location landmark subsurfacefeature. In an embodiment, the location analysis circuit is configuredto determine a distance from the distal end portion of thebody-insertable device to the destination region of interest. Thedistance determination is at least partially based on the third spatialrelationship.

In an embodiment, the indicator circuit 5128 is configured to generateinformational data indicative of an operational proximity of the distalend portion of the body-insertable device to the destination region ofinterest. The informational data is at least partially based on thedetermined fourth spatial relationship. In an embodiment, the indicatoris configured to generate informational data indicative of a distance ofless than four centimeters between the distal end portion of thebody-insertable device and the destination region of interest. In anembodiment, the indicator is configured to generate informational dataindicative of a distance of less than two centimeters between the distalend portion of the body-insertable device and the destination region ofinterest. In an embodiment, the indicator is configured to generateinformational data indicative of a distance of less than one hundredmillimeters between the distal end portion of the body-insertable deviceand the destination region of interest. In an embodiment, the indicatoris configured to generate informational data indicative of a distancefrom the distal end portion of the body-insertable device to thedestination region of interest. The informational data is at leastpartially based on the determined fourth spatial relationship, and theindicated distance is within a user-selected range. For example, theuser-selected range may be within 2 cm.

In an embodiment, the system 5120 may include a guidance circuit 5136configured to determine a movement of the distal end portion of thebody-insertable device to produce a particular change in the spatialrelationship between the distal end portion of the body-insertabledevice and the destination region of interest. The movement is at leastpartially based on the informational data indicative of the determinedfourth spatial relationship between the destination region of interestand the distal end portion of the body-insertable device.

In an embodiment, the guidance circuit 5136 is configured to determine amovement of the distal end portion of the body-insertable device toproduce a user-selected change of the spatial relationship between thedistal end portion of the body-insertable device and the destinationregion of interest. The movement is at least partially based on theinformational data indicative of the determined fourth spatialrelationship between the destination region of interest and the distalend portion of the body-insertable device. For example, a selectedchange may include a decrease of the spatial relationship between theportion of the body-insertable device and the region of interest. Forexample, a selected change may include an increase of the spatialrelationship between the portion of the body-insertable device and theregion of interest. For example, a selected change may include an axialrotation of the distal end portion of the body-insertable device into analignment with the region of interest. In an embodiment, the guidancecircuit is configured to select a movement of the distal end portion ofthe body-insertable device likely to produce a machine-selected changeof the spatial relationship between the distal end portion of thebody-insertable device and the destination region of interest. In anembodiment, the guidance circuit is configured to determine arotational, radial, or axial movement of the distal end portion of thebody-insertable device to produce a particular change in the spatialrelationship between the distal end portion of the body-insertabledevice and the destination region of interest. In an embodiment, theguidance circuit is configured to determine a movement of the distal endportion of the body-insertable device to decrease a separation betweenthe spatial relationship between the distal end portion of thebody-insertable device and the destination region of interest. In anembodiment, the guidance circuit is configured to determine a movementof the distal end portion of the body-insertable device to increase aseparation between the spatial relationship between the distal endportion of the body-insertable device and the destination region ofinterest. In an embodiment, the indicator circuit 5128 is configured togenerate informational data indicative of the determined movement of thedistal end portion of the body-insertable device to produce a particularchange in the spatial relationship between the distal end portion of thebody-insertable device and the destination region of interest. In anembodiment, the indicator circuit 5128 is configured to generateinformational data indicative of the determined movement of the distalend portion of the body-insertable device to produce a particular changein the spatial relationship between the distal end portion of thebody-insertable device and the destination region of interest. Theinformational data is useable in facilitating an action performed by thebody-insertable device relative to the destination region of interest.

In an embodiment, the system 5120 includes a communication circuit 5142configured to output the informational data. In an embodiment, thecommunication circuit is configured to provide a notification that is atleast partially based on the informational data to at least one of ahuman, computer, or system. In an embodiment, the system includes acommunication device, illustrated as the computing device 292,configured to display on the screen 294 a human-perceivable depiction ofthe informational data.

FIG. 104 illustrates an example operational flow 5300 implemented usinga computing device. The operational flow includes a start operation. Theoperational flow includes a first reception operation 5310. The firstreception operation includes a first reference image that includes anobjective landmark subsurface feature of a mammalian body part. Theobjective landmark subsurface feature has a first spatial relationshipto a destination region of interest of the mammalian body part. A secondreception operation 5320 includes receiving a second reference imagethat includes a present-location landmark subsurface feature of themammalian body part. The present-location landmark subsurface featurehas a second spatial relationship to a distal end portion of abody-insertable device deployed operationally proximate to the mammalianbody part. In an embodiment, the first reception operation or the secondreception operation may be implemented using the receiver circuit 5122described in conjunction with FIG. 102. A first matching operation 5330includes determining a substantial correspondence between the objectivelandmark subsurface feature and a first atlas subsurface featureincluded in a subsurface feature atlas of the mammalian body part. Thesubsurface feature atlas includes at least two registered subsurfacefeatures of the mammalian body part. The at least two registeredsubsurface features includes the first atlas subsurface feature and asecond atlas subsurface feature. The registration includes an indicationof a third spatial relationship between the first atlas subsurfacefeature and the second atlas subsurface feature. A second matchingoperation 5340 includes determining a substantial correspondence betweenthe present-location landmark subsurface feature and the second atlassubsurface feature included in the subsurface feature atlas of themammalian body part. In an embodiment, the first matching operation orthe second matching operation may be implemented using the featurematching circuit 5124 described in conjunction with FIG. 102. Aproximity operation 5350 includes determining a fourth spatialrelationship between the destination region of interest and the distalend portion of the body-insertable device deployed operationallyproximate to the mammalian body part. The determined fourth spatialrelationship is at least partially based on the third spatialrelationship. In an embodiment, the proximity operation may beimplemented using the location analysis circuit 5126 described inconjunction with FIG. 102. A communication operation 5360 includesoutputting informational data indicative of the determined fourthspatial relationship between the destination region of interest and thedistal end portion of the body-insertable device. In an embodiment, thecommunication operation may be implemented using the communicationcircuit 5142 described in conjunction with FIG. 102. The operationalflow includes an end operation.

FIG. 105 illustrates an alternative embodiment of the first receptionoperation 5310 of the operational flow 5300 of FIG. 104. The firstreception operation may include at least one alternative embodiment. Theat least one alternative embodiments may include an operation 5311, anoperation 5312, an operation 5313, an operation 5314, an operation 5315,an operation 5316, an operation 5317, or an operation 5318. Theoperation 5311 includes receiving a first reference image that includesan objective landmark subsurface feature of a mammalian body part. Theobjective landmark subsurface feature has a first spatial relationshipto a destination region of interest of the mammalian body part and isdistinguishable over other landmark subsurface features of the mammalianbody part. The operation 5312 includes a first reference image thatincludes an objective landmark subsurface feature of a mammalian bodypart. The objective landmark subsurface feature has an indicated,determinable, estimable, or inferable first spatial relationship to adestination region of interest of the mammalian body part. The operation5313 includes receiving a first reference image that includes areference landmark subsurface feature of a mammalian body part. Thereference landmark subsurface feature has a first spatial relationshipto a destination region of interest of a cavity or lumen of themammalian body part. The operation 5314 includes receiving a firstreference image that includes an objective landmark subsurface featureof a mammalian body part. The objective landmark subsurface feature hasa first spatial relationship to a destination region of interest of asurface of a cavity or lumen of the mammalian body part. The operation5315 includes receiving a first reference image acquired by an ex vivodevice and including an objective landmark subsurface feature of amammalian body part. The objective landmark subsurface feature has afirst spatial relationship to a destination region of interest of themammalian body part. The operation 5316 includes receiving a firstreference image acquired by the body-insertable device and includes anobjective landmark subsurface feature of a mammalian body part. Theobjective landmark subsurface feature has a first spatial relationshipto a destination region of interest of the mammalian body part. Theoperation 5317 includes receiving a first reference image that includesan objective landmark subsurface feature of a mammalian body part. Theobjective landmark subsurface feature has a first spatial relationshipto a human-user selected destination region of interest of the mammalianbody part. The operation 5318 includes receiving a first reference imagethat includes an objective landmark subsurface feature of a mammalianbody part. The objective landmark subsurface feature has a first spatialrelationship to a machine-selected destination region of interest of themammalian body part.

FIG. 106 illustrates an alternative embodiment of the second receptionoperation 5320 of the operational flow 5300 of FIG. 104. The secondreception operation may include at least one alternative embodiment. Theat least one alternative embodiments may include an operation 5321, anoperation 5322, an operation 5323, an operation 5324, or an operation5325. The operation 5321 includes receiving a second reference imagethat includes a present-location landmark subsurface feature of themammalian body part. The present-location landmark subsurface featurehas a second spatial relationship to an effector carried by a distal endportion of a body-insertable device and deployed operationally proximateto the mammalian body part. The operation 5322 includes receiving asecond reference image that includes a present-location landmarksubsurface feature of the mammalian body part. The present-locationlandmark subsurface feature has a second spatial relationship to anoperative and movable distal end portion of a body-insertable devicedeployed operationally proximate to the mammalian body part. Theoperation 5323 includes receiving a second reference image that includesa present-location landmark subsurface feature of the mammalian bodypart. The present-location landmark subsurface feature has a secondspatial relationship to a distal end portion of a body-insertable devicedeployed in a cavity or lumen of the mammalian body part. The operation5324 includes receiving a second reference image acquired by abody-insertable device and includes a present-location landmarksubsurface feature of the mammalian body part. The present-locationlandmark subsurface feature has a second spatial relationship to adistal end portion of the body-insertable device deployed operationallyproximate to the mammalian body part. The operation 5325 includesreceiving a second reference image acquired by an ex vivo device andincludes a present-location landmark subsurface feature of the mammalianbody part. The present-location landmark subsurface feature has a secondspatial relationship to a distal end portion of the body-insertabledevice deployed operationally proximate to the mammalian body part.

FIG. 107 illustrates an alternative embodiment of the operational flow5300 of FIG. 104. In an embodiment, the first matching operation 5330may include at least one alternative embodiment. The at least onealternative embodiments may include an operation 5331 or an operation5332. The operation 5331 includes determining at least one of asubstantial structural, orientation, pattern, or physical characteristiccorrespondence between the objective landmark subsurface feature and afirst atlas subsurface feature included in a subsurface feature atlas ofthe mammalian body part. The operation 5332 includes determining asubstantial match between the objective landmark subsurface feature anda first atlas subsurface feature included in a subsurface feature atlasof the mammalian body part. In an embodiment, the second matchingoperation 5340 may include at least one alternative embodiment. The atleast one alternative embodiments may include an operation 5341 or 5342.The operation 5341 includes determining at least one of a substantialstructural, orientation, pattern, or physical characteristiccorrespondence between the present-location landmark subsurface featureand a second atlas subsurface feature included in the subsurface featureatlas of the mammalian body part. The operation 5342 includesdetermining a substantial match between the present-location landmarksubsurface feature and a second atlas subsurface feature included in thesubsurface feature atlas of the mammalian body part.

FIG. 108 illustrates an alternative embodiment of the operational flow5300 of FIG. 104. In an embodiment, the proximity operation 5350 mayinclude at least one additional embodiment. The at least one additionaloperation may include an operation 5351 or an operation 5352. Theoperation 5351 includes determining a fourth spatial relationshipbetween the destination region of interest and the distal end portion ofthe body-insertable device deployed operationally proximate to themammalian body part. The fourth spatial relationship is determined atleast partially in response to: (i) a fifth spatial relationship betweenthe objective landmark subsurface feature and the present-locationlandmark subsurface feature, the determination is at least partiallybased on a spatial relationship between the first atlas subsurfacefeature and the second atlas subsurface feature as indicated by thesubsurface feature atlas; (ii) the first spatial relationship betweenthe destination region of interest and the objective landmark subsurfacefeature; and (iii) the second spatial relationship between the distalend portion of the body-insertable device and the present-locationlandmark subsurface feature. In an embodiment, the determining a fourthspatial relationship includes determining a distance, a rotation, or adirection between the destination region of interest and the distal endportion of the body-insertable device deployed operationally proximateto the mammalian body part. The operation 5352 includes determining adistance from the distal end portion of the body-insertable device tothe destination region of interest. The distance determination is atleast partially based on the third spatial relationship.

In an embodiment, the communication operation 5360 may include at leastone additional embodiment. The at least one additional embodiment mayinclude an operation 5361, an operation 5362, or an operation 5363. Theoperation 5361 includes outputting a signal usable in displaying ahuman-perceivable depiction of the informational data. The operation5362 includes transforming the informational data into a signal usablein displaying a particular visual indication of the determined fourthspatial relationship between the destination region of interest and thedistal end portion of the body-insertable device, and outputting thesignal. The operation 5363 includes outputting informational dataindicative of a movement of the distal end portion of thebody-insertable device to produce a particular change in the spatialrelationship between the distal end portion of the body-insertabledevice and the destination region of interest.

FIG. 109 illustrates an alternative embodiment of the operational flow5300 of FIG. 104. In an embodiment, the operational flow may include aguidance operation 5370. The guidance operation includes determining amovement of the distal end portion of the body-insertable device toproduce a particular change in the spatial relationship between thedistal end portion of the body-insertable device and the destinationregion of interest. The movement is at least partially based on theinformational data indicative of the determined fourth spatialrelationship between the destination region of interest and the distalend portion of the body-insertable device. In an embodiment, theguidance operation may be implemented using the guidance circuit 5136described in conjunction with FIG. 102.

In an embodiment, the guidance operation may include at least oneadditional embodiment. The at least one additional embodiment mayinclude an operation 5371, an operation 5372, an operation 5373, anoperation 5374, an operation 5375, or an operation 5376. The operation5371 includes determining a movement of the distal end portion of thebody-insertable device to produce a produce a user-selected change inthe spatial relationship between the distal end portion of thebody-insertable device and the destination region of interest. Thedetermined movement is at least partially based on the informationaldata indicative of the determined fourth spatial relationship betweenthe destination region of interest and the distal end portion of thebody-insertable device. The operation 5372 includes determining amovement of the distal end portion of the body-insertable device toproduce a machine-selected change in the spatial relationship betweenthe distal end portion of the body-insertable device and the destinationregion of interest. The movement is determined at least partially basedon the informational data indicative of the determined fourth spatialrelationship between the destination region of interest and the distalend portion of the body-insertable device. In an embodiment, theoperation 5373 includes determining a rotational, radial, or axialmovement of the distal end portion of the body-insertable device toproduce a particular change in the spatial relationship between thedistal end portion of the body-insertable device and the destinationregion of interest. The movement is determined at least partially basedon the informational data indicative of the determined fourth spatialrelationship between the destination region of interest and the distalend portion of the body-insertable device. In an embodiment, theoperation 5374 includes determining a movement of the portion of thebody-insertable device operable to decrease a separation between theportion of the body-insertable device and the region of interest. Themovement is determined at least partially based on the determined fourthspatial relationship between the reference landmark subsurface featureand present-location landmark subsurface feature. In an embodiment, theoperation 5375 includes a movement of the distal end portion of thebody-insertable device to increase a separation between the spatial inthe spatial relationship between the distal end portion of thebody-insertable device and the destination region of interest. Themovement is determined at least partially based on the informationaldata indicative of the determined fourth spatial relationship betweenthe destination region of interest and the distal end portion of thebody-insertable device. In an embodiment, the operation 5376 includesdetermining a movement of the distal end portion of the body-insertabledevice, the determined movement useable in facilitating a performance ofan action by the distal end portion of the body-insertable device. Themovement is determined at least partially based on the informationaldata indicative of the determined fourth spatial relationship betweenthe destination region of interest and the distal end portion of thebody-insertable device.

FIG. 110 illustrates an alternative embodiment of the operational flow5300 of FIG. 104. In an embodiment, the operational flow may include atleast one additional embodiment 5380. In an embodiment, the at least oneadditional embodiment may include an operation 5381, an operation 5382,or an operation 5383. The operation 5381 includes maintaining theinformational data in a computer-readable media. The operation 5382includes providing a notification that is at least partially based onthe informational data to at least one of a human, computer, or system.The operation 5383 includes maintaining the atlas of the mammalian bodyin the computer-readable media. The atlas includes a respective spatialrelationship between at least two registered atlas subsurface featuresof the mammalian body part. In an embodiment, the atlas may have beenprepared prior to the capture of the first reference image or the secondreference image. In an embodiment, the atlas may be a general atlas ofthe mammalian body part.

FIG. 111 illustrates an example computer program product 5400. Thecomputer program product includes a computer-readable media 5410 bearingprogram instructions 5420. The program instructions, when executed by aprocessor of a computing device, cause the computing device to perform aprocess. The process includes receiving a first reference image thatincludes an objective landmark subsurface feature of a mammalian bodypart. The objective landmark subsurface feature has a first spatialrelationship to a destination region of interest of the mammalian bodypart. The process includes receiving a second reference image thatincludes a present-location landmark subsurface feature of the mammalianbody part. The present-location landmark subsurface feature has a secondspatial relationship to a distal end portion of a body-insertable devicedeployed operationally proximate to the mammalian body part. The processincludes determining a substantial correspondence between the objectivelandmark subsurface feature and a first atlas subsurface featureincluded in a subsurface feature atlas of the mammalian body part. Thesubsurface feature atlas includes at least two registered subsurfacefeatures of the mammalian body part, including the first atlassubsurface feature and a second atlas subsurface feature. Theregistration includes an indication of a third spatial relationshipbetween the first atlas subsurface feature and the second atlassubsurface feature. The process includes determining a substantialcorrespondence between the present-location landmark subsurface featureand the second atlas subsurface feature included in the subsurfacefeature atlas of the mammalian body part. The process includesdetermining a fourth spatial relationship between the destination regionof interest and the distal end portion of the body-insertable devicedeployed operationally proximate to the mammalian body part. Thedetermined fourth spatial relationship is at least partially based onthe third spatial relationship. The process includes outputtinginformational data indicative of the determined fourth spatialrelationship between the destination region of interest and the distalend portion of the body-insertable device.

In an embodiment, the computer-readable media 5410 includes a tangiblecomputer-readable media 5412. In an embodiment, the computer-readablemedia includes a communications medium 5414.

FIG. 112 illustrates an alternative embodiment of the computer programproduct 5400 of FIG. 111. In an embodiment, the process includes 5422transforming the informational data into a signal usable in displaying aparticular visual indication of the determined fourth spatialrelationship between the destination region of interest and the distalend portion of the body-insertable device, and outputting the data. Inan embodiment, the process further includes 5424 providing anotification that is at least partially based on the informational datato at least one of a human, computer, or system. In an embodiment, theprocess further includes 5426 storing the informational data in anothercomputer-readable media operably coupled with the processor.

FIG. 113 illustrates an example system 5500. The system includes means5510 for receiving a first reference image that includes an objectivelandmark subsurface feature of a mammalian body part. The objectivelandmark subsurface feature has a first spatial relationship to adestination region of interest of the mammalian body part. The systemincludes means 5520 for receiving a second reference image that includesa present-location landmark subsurface feature of the mammalian bodypart. The present-location landmark subsurface feature has a secondspatial relationship to a distal end portion of a body-insertable devicedeployed operationally proximate to the mammalian body part. The systemincludes means 5530 for determining a substantial correspondence betweenthe objective landmark subsurface feature and a first atlas subsurfacefeature included in a subsurface feature atlas of the mammalian bodypart. The subsurface feature atlas includes at least two registeredsubsurface features of the mammalian body part, including the firstatlas subsurface feature and a second atlas subsurface feature. Theregistration includes an indication of a third spatial relationshipbetween the first atlas subsurface feature and the second atlassubsurface feature. The system includes means 5540 for determining asubstantial correspondence between the present-location landmarksubsurface feature and the second atlas subsurface feature included inthe subsurface feature atlas of the mammalian body part. The systemincludes means 5550 for determining a fourth spatial relationshipbetween the destination region of interest and the distal end portion ofthe body-insertable device deployed operationally proximate to themammalian body part. The fourth spatial relationship is determined atleast partially based on the third spatial relationship. The systemincludes means 5560 for outputting informational data indicative of thedetermined fourth spatial relationship between the destination region ofinterest and the distal end portion of the body-insertable device.

Returning to FIG. 102, FIG. 102 illustrates alternative embodiment ofthe system 5120. In the alternative embodiment, the feature matchingcircuit 5124 is configured to determine a substantial correspondencebetween an objective landmark subsurface feature of a mammalian bodypart and a first atlas subsurface feature included in a subsurfacefeature atlas. The objective landmark subsurface feature has a firstspatial relationship to a destination region of interest of themammalian body part. The subsurface feature atlas includes at least tworegistered subsurface features of the mammalian body part including thefirst atlas subsurface feature and a second atlas subsurface feature.The feature matching circuit is also configured to determine asubstantial correspondence between a present-location landmarksubsurface feature of the mammalian body part and the second atlassubsurface feature included in the subsurface feature atlas. Thepresent-location landmark subsurface feature has a second spatialrelationship to a distal end portion of a body-insertable devicedeployed operationally proximate to the mammalian body part.

In the alternative embodiment, the location analysis circuit 5126 isconfigured to determine a fourth spatial relationship between thedestination region of interest and the distal end portion of thebody-insertable device deployed operationally proximate to the mammalianbody part. The fourth spatial relationship is determined at leastpartially based on the third spatial relationship. In the alternativeembodiment, the indicator circuit 5128 is configured to generateinformational data indicative of the determined fourth spatialrelationship between the destination region of interest and the distalend portion of the body-insertable device. The informational data is atleast partially based on the fourth spatial relationship between thedestination region of interest and the distal end portion of thebody-insertable device. In the alternative embodiment, thecomputer-readable media 235 is configured to maintain informationaldata.

FIG. 114 illustrates an example operational flow 5600. The operationalflow includes a start operation. The operational flow includes a firstmatching operation 5610. The first matching operation includesdetermining a substantial correspondence between an objective landmarksubsurface feature of a mammalian body part and a first atlas subsurfacefeature included in a subsurface feature atlas. The objective landmarksubsurface feature has a first spatial relationship to a destinationregion of interest of the mammalian body part. The subsurface featureatlas includes at least two registered subsurface features of themammalian body part including the first atlas subsurface feature and asecond atlas subsurface feature. A second matching operation 5620includes determining a substantial correspondence between apresent-location landmark subsurface feature the mammalian body part andthe second atlas subsurface feature included in the subsurface featureatlas. The present-location landmark subsurface feature has a secondspatial relationship to a distal end portion of a body-insertable devicedeployed operationally proximate to the mammalian body part. A proximityoperation 5630 includes determining a fourth spatial relationshipbetween the destination region of interest and the distal end portion ofthe body-insertable device deployed operationally proximate to themammalian body part. The fourth spatial relationship is determined atleast partially based on the third spatial relationship. A communicationoperation 5650 includes outputting the informational data.

FIG. 115 illustrates an example environment 5700. The environmentincludes the mammalian body part 210 of an individual patientillustrated as the mammal 205, and a system 5720. The system includes areceiver circuit 5722 configured to receive first medical image thatincludes a selected target region of interest of a body part of anindividual patient (hereafter “individual patient body part”). The firstmedical image also includes a landmark subsurface feature of theindividual patient body part having a first spatial relationship withthe selected target region of interest (hereafter “associated landmarksubsurface feature”). For example, the first digital image may beprovided by a human or a machine. For example, the region of interestmay be indicated by a human, machine, a feature choosing circuit, or byan atlas of the patient body part. The receiver circuit is alsoconfigured to receive a second medical image that includes a candidateregion of interest of the individual patient body part. The secondmedical image also includes a landmark feature of the individual patientbody part having a second spatial relationship with the candidate regionof interest (hereafter “candidate landmark subsurface feature”). Thesystem includes a feature matching circuit 5724 configured to determinea substantial correspondence between the candidate landmark subsurfacefeature and the associated landmark subsurface feature. A reportingcircuit 5736 is to generate informational data indicating the secondmedical image includes at least a portion of the selected target regionof interest. The informational data is at least partially based on thedetermined substantial correspondence between the candidate landmarksubsurface feature and the associated landmark subsurface feature. Thesystem includes a communication circuit 5742 configured to output theinformational data.

For example, in an embodiment of the system 5720 in use, the system maybe used in conjunction with a follow-up colonoscopy. The first medicalimage may include an image that was acquired during a previouscolonoscopy, and may include a suspicious polyp that the physicianselects as a target region of interest to follow in a future exam. Thesecond medical image may include an image that was acquired during afollow-up exam one year later. The feature matching circuit 5724determines whether a substantial correspondence exists between thecandidate landmark subsurface feature of the second or subsequentmedical image and the associated landmark subsurface feature of thefirst medical image. If a substantial correspondence exists between thelandmark subsurface features, the reporting circuit 5736 generatesinformational data indicating the second medical image includes at leasta portion of the selected target region of interest. The communicationcircuit 5742 outputs the informational data. The informational dataindicates to the physician that the second digital image includes atleast a portion of the selected target region of interest.

For example, in another embodiment of the system 5720 in use, the firstmedical image depicts a selected target region of interest of theindividual patient body part 210, and depicts a landmark subsurfacefeature of the individual patient body part has a first spatialrelationship with the selected target region of interest (the“associated landmark subsurface feature”). The second medical imagedepicts a candidate region of interest of the individual patient bodypart, and includes a landmark feature of the individual patient bodypart having a second spatial relationship with the candidate region ofinterest (the “candidate landmark subsurface feature.”) If the featurematching circuit determines a substantial correspondence between thecandidate landmark subsurface feature and the associated landmarksubsurface feature, and if feature matching circuit determines asubstantial correspondence between the first spatial relationship andthe second spatial relationship, the reporting circuit 5736 generatesinformational data indicating the second medical image includes at leasta portion of the selected target region of interest. The communicationcircuit 5742 outputs the informational data. The informational dataindicates to the physician that the second digital image includes atleast a portion of the selected target region of interest.

In an embodiment, the first medical image includes a selected targetregion of interest of a cavity or lumen 211 of an individual patientbody part 210, and includes an associated landmark subsurface feature.In an embodiment, the second medical image includes a candidate regionof interest of the cavity or lumen of the individual patient body part,and includes a candidate landmark subsurface feature. In an embodiment,the first medical image includes a target region of interest thatincludes a selected target region of interest of a surface of a cavityor lumen of an individual patient body part, and includes an associatedlandmark subsurface feature. In an embodiment, the second medical imageincludes a candidate region of interest of the surface of the cavity orlumen of the individual patient body part, and includes a candidatelandmark subsurface feature. In an embodiment, the first medical imageincludes a selected surface region of interest of an individual patientbody part, and includes an associated landmark subsurface feature. In anembodiment, the second medical image includes a candidate surface regionof interest of the individual patient body part, and includes acandidate landmark feature of the individual patient body part. In anembodiment, the first medical image includes a selected subsurfaceregion of interest of an individual patient body part, and includes anassociated landmark subsurface feature. In an embodiment, the secondmedical image includes a candidate subsurface region of interest of theindividual patient body part, and includes a candidate landmark featureof the individual patient body part. In an embodiment, the first medicalimage includes a selected target region of interest of an individualpatient body part, and includes an associated landmark subsurfacefeature machine-distinguishable from other landmark features of theindividual patient body part. In an embodiment, the second medical imageincludes a candidate region of interest of the individual patient bodypart, and includes a candidate landmark feature of the individualpatient body part machine-distinguishable from other landmark featuresof the individual patient body part. In an embodiment, the first medicalimage includes a machine-selected target region of interest of anindividual patient body part, and that includes an associated landmarksubsurface feature. In an embodiment, the first medical image includes ahuman-selected target region of interest of an individual patient bodypart, and that includes an associated landmark subsurface feature.

In an embodiment, the feature matching circuit 5724 is configured todetermine a substantial correspondence between the candidate landmarksubsurface feature and the associated landmark subsurface feature, andto determine a substantial correspondence between the first spatialrelationship and the second spatial relationship. In an embodiment, thereporting circuit 5736 is configured to generate informational dataindicating the second medical image includes at least a portion of theselected target region of interest, the informational data is at leastpartially based on (i) the determined substantial correspondence betweenthe candidate landmark subsurface feature and the associated landmarksubsurface feature, and (ii) the determined substantial correspondencebetween the first spatial relationship and the second spatialrelationship. In an embodiment, the reporting circuit configured togenerate informational data indicating the second medical image includesat least a portion of the selected target region of interest, theinformational data is at least partially based on (i) the determinedsubstantial correspondence between the candidate landmark subsurfacefeature and the associated landmark subsurface feature, (ii) the firstspatial relationship between the selected target region of interest andthe associated landmark subsurface feature, and (iii) the second spatialrelationship between the candidate region of interest and the candidatelandmark subsurface feature. In an embodiment, the feature matchingcircuit is configured to determine at least one of a structural,pattern, orientation, physical characteristic, or identification-basedsubstantial correspondence between the candidate landmark subsurfacefeature and the associated landmark subsurface feature. In anembodiment, the reporting circuit is configured to generateinformational data indicating the candidate region of interest of thesecond medical image includes at least a portion of the selected targetregion of interest, the informational data is at least partially basedon the determined substantial correspondence between the candidatelandmark subsurface feature and the associated landmark subsurfacefeature. In an embodiment, the reporting circuit is configured togenerate informational data indicating the second medical image includesat least a portion of the selected target region of interest, theinformational data is at least partially based on the determinedsubstantial correspondence between the candidate landmark subsurfacefeature and the associated landmark subsurface feature; otherwise thereporting circuit is configured to generate informational dataindicating the second medical image does not include the target regionof interest. The another informational data is at least partially basedon an absence of a determined substantial correspondence between thecandidate landmark subsurface feature and the associated landmarksubsurface feature.

In an embodiment, the communication circuit 5742 is configured toprovide a notification that is at least partially based on theinformational data to at least one of a human, computer, or system. Inan embodiment, the system 5720 may include an indicator circuit 5728configured to display a human-perceivable indication that the secondmedical image includes at least a portion of the target region ofinterest. In an embodiment, the system may include a computer-readablemedia configured to maintain the informational data, such as thecomputer-readable media 235.

FIG. 116 illustrates an example operational flow 5800. The operationalflow includes a start operation. The operational flow includes a firstreception operation 5810. The first reception operation includesreceiving a first medical image that includes a selected target regionof interest of a body part of an individual patient (hereafter“individual patient body part”). The first medical image also includes alandmark subsurface feature of the individual patient body part having afirst spatial relationship with the selected target region of interest(hereafter “associated landmark subsurface feature”). A second receptionoperation 5820 includes receiving a second medical image that includes acandidate region of interest of the individual patient body part, andthat includes a landmark feature of the individual patient body parthaving a second spatial relationship with the candidate region ofinterest (hereafter “candidate landmark subsurface feature”). In anembodiment, the first reception operation or the second receptionoperation may be performed using the receiver circuit 5722 described inconjunction with FIG. 115. A matching operation 5830 includesdetermining a substantial correspondence between the candidate landmarksubsurface feature and the associated landmark subsurface feature. In anembodiment, the matching operation may be implemented using the featurematching circuit 5724 described in conjunction with FIG. 115. Areporting operation 5840 includes generating informational dataindicating the second medical image includes at least a portion of theselected target region of interest. The informational data is at leastpartially based on the determined substantial correspondence between thecandidate landmark subsurface feature and the associated landmarksubsurface feature. In an embodiment, the reporting operation may beimplement using the reporting circuit 5736 described in conjunction withFIG. 115. A communication operation 5850 includes outputting theinformational data. In an embodiment, the communication operation may beimplemented using the communications circuit 5742 described inconjunction with FIG. 115. The operational flow includes an endoperation.

FIG. 117 illustrates an alternative embodiment of the operational flow5800 of FIG. 116. In an embodiment, the first receiving operation 5810may include at least one alternative embodiment. The at least onealternative embodiment may include an operation 5811, an operation 5812,an operation 5813, an operation 5814, or an operation 5815. In anembodiment, the operation 5811 includes receiving a first medical imagethat includes a selected target region of interest of a cavity or lumenof an individual patient body part, and that includes an associatedlandmark subsurface feature. In an operation, the operation 5812includes receiving a first medical image that includes a target regionof interest that includes a selected target region of interest of asurface of a cavity or lumen of an individual patient body part, andthat includes an associated landmark subsurface feature. In anembodiment, the operation 5813 includes receiving a first medical imagethat includes a selected surface region of interest of an individualpatient body part, and that includes an associated landmark subsurfacefeature. In an embodiment, the operation 5814 includes receiving a firstmedical image that includes a selected subsurface region of interest ofan individual patient body part, and that includes an associatedlandmark subsurface feature. In an embodiment, the operation 5815includes receiving a first medical image that includes a selected targetregion of interest of an individual patient body part, and that includesan associated landmark subsurface feature machine-distinguishable fromother landmark features of the individual patient body part.

In an embodiment, the second receiving operation 5820 may include atleast one alternative embodiment. The at least one alternativeembodiment may include an operation 5821, an operation 5822, anoperation 5823, an operation 5824, or an operation 5825. In anembodiment, the operation 5821 includes receiving a second medical imagethat includes a candidate region of interest of the cavity or lumen ofthe individual patient body part, and that includes a candidate landmarksubsurface feature. In an embodiment, the operation 5822 includesreceiving a second medical image that includes a candidate region ofinterest of the surface of the cavity or lumen of the individual patientbody part, and that includes a candidate landmark subsurface feature. Inan embodiment, the operation 5823 includes receiving a second medicalimage that includes a candidate surface region of interest of theindividual patient body part, and that includes a candidate landmarkfeature of the individual patient body part. In an embodiment, theoperation 5824 includes receiving a first medical image that includes aselected subsurface region of interest of an individual patient bodypart, and that includes an associated landmark subsurface feature.

FIG. 118 illustrates an alternative embodiment of the operational flow5800 of FIG. 116. In an embodiment, the matching operation 5830 includesat least one alternative embodiment. The at least alternative embodimentmay include an operation 5831 or an operation 5832. The operation 5831includes determining a substantial correspondence between the candidatelandmark subsurface feature and the associated landmark subsurfacefeature, and determining a substantial correspondence between the firstspatial relationship and the second spatial relationship. The operation5832 includes determining at least one of a structural, pattern,orientation, physical characteristic, or identification-basedsubstantial correspondence between the candidate landmark subsurfacefeature and the associated landmark subsurface feature.

In an embodiment, the reporting operation 5840 may include at least onealternative embodiment. The at least one alternative embodiment mayinclude an operation 5841, an operation 5842, an operation 5843, or anoperation 5844. The operation 5841 includes generating informationaldata indicating the second medical image includes at least a portion ofthe selected target region of interest. The informational data is atleast partially based on (i) the determined substantial correspondencebetween the candidate landmark subsurface feature and the associatedlandmark subsurface feature, and (ii) the determined substantialcorrespondence between the first spatial relationship and the secondspatial relationship. The operation 5842 includes generatinginformational data indicating the second medical image includes at leasta portion of the selected target region of interest. The informationaldata is at least partially based on (i) the determined substantialcorrespondence between the candidate landmark subsurface feature and theassociated landmark subsurface feature, (ii) the first spatialrelationship between the selected target region of interest and theassociated landmark subsurface feature, and (iii) the second spatialrelationship between the candidate region of interest and the candidatelandmark subsurface feature. The operation 5843 includes generatinginformational data indicating the candidate region of interest of thesecond medical image includes at least a portion of the selected targetregion of interest. The informational data is at least partially basedon the determined substantial correspondence between the candidatelandmark subsurface feature and the associated landmark subsurfacefeature. The operation 5844 includes generating informational dataindicating the second medical image includes at least a portion of theselected target region of interest; the informational data is at leastpartially based on the determined substantial correspondence between thecandidate landmark subsurface feature and the associated landmarksubsurface feature—otherwise generating informational data indicatingthe second medical image does not include the target region of interest;the another informational data is at least partially based on an absenceof a determined substantial correspondence between the candidatelandmark subsurface feature and the associated landmark subsurfacefeature.

FIG. 119 illustrates an alternative embodiment of the operational flow5800 of FIG. 116. In an embodiment, the operational flow may include atleast one alternative embodiment 5860. The at least one alternativeembodiment may include an operation 5861, an operation 5862, anoperation 5863, or an operation 5864. The operation 5861 includesproviding a notification that is at least partially based on theinformational data to at least one of a human, computer, or system. Theoperation 5862 includes displaying a human-perceivable indication thatthe second medical image includes at least a portion of the targetregion of interest. The operation 5863 includes maintaining theinformational data in a computer-readable media. The operation 5864includes transforming the informational data into a signal usable indisplaying a particular visual indication that the second medical imageincludes at least a portion of the selected target region of interest.

FIG. 120 illustrates a computer program product. The computer programproduct includes a computer-readable computer storage medium 5910bearing program instructions 5920. The program instructions which, whenexecuted by a processor of a computing device, cause the computingdevice to perform a process. The process includes receiving a firstmedical image that includes a selected target region of interest of abody part of an individual patient (hereafter “individual patient bodypart”). The first medical image also includes a landmark subsurfacefeature of the individual patient body part having a first spatialrelationship with the selected target region of interest (hereafter“associated landmark subsurface feature”). The process includesreceiving a second medical image that includes a candidate region ofinterest of the individual patient body part. The second medical imagealso includes a landmark feature of the individual patient body parthaving a second spatial relationship with the candidate region ofinterest (hereafter “candidate landmark subsurface feature”). Theprocess includes determining a substantial correspondence between thecandidate landmark subsurface feature and the associated landmarksubsurface feature. The process includes generating informational dataindicating the second medical image includes at least a portion of theselected target region of interest. The informational data is at leastpartially based on the determined substantial correspondence between thecandidate landmark subsurface feature and the associated landmarksubsurface feature. The process includes outputting the informationaldata.

In an embodiment, the process further includes 5922 storing theinformational data in another computer-readable media operably coupledwith the processor. In an embodiment, the process further includes 5924transforming the informational data into a signal usable in providing aparticular visual indication that the second medical image includes atleast a portion of the selected target region of interest. In anembodiment, the process further includes 5926 providing a notificationthat is at least partially based on the informational data to at leastone of a human, computer, or system.

In an embodiment, the computer-readable media 5910 includes a tangiblecomputer-readable media 5912. In an embodiment, the computer-readablemedia includes a communications medium 5914.

FIG. 121 illustrates an example system 6000. The system includes means6010 for receiving a first medical image that includes a selected targetregion of interest of a body part of an individual patient (hereafter“individual patient body part”). The first medical image also includes alandmark subsurface feature of the individual patient body part having afirst spatial relationship with the selected target region of interest(hereafter “associated landmark subsurface feature”). The systemincludes means 6020 for receiving a second medical image that includes acandidate region of interest of the individual patient body part, andthat includes a landmark feature of the individual patient body parthaving a second spatial relationship with the candidate region ofinterest (hereafter “candidate landmark subsurface feature”). The systemincludes means 6030 for determining a substantial correspondence betweenthe candidate landmark subsurface feature and the associated landmarksubsurface feature. The system include means 6040 for generatinginformational data indicating the second medical image includes at leasta portion of the selected target region of interest, the informationaldata is at least partially based on the determined substantialcorrespondence between the candidate landmark subsurface feature and theassociated landmark subsurface feature. The system includes means 6050for outputting the informational data.

In an alternative embodiment, the system 6000 may includes means 6060for persistently maintaining the informational data. In an embodiment,the system includes means 6070 for transforming the informational datainto a signal usable in providing a particular visual indication thatthe second medical image includes at least a portion of the selectedtarget region of interest.

FIG. 122 illustrates an example environment 6100. The environmentincludes the mammalian body part 210 of an individual patientillustrated as the mammal 205, the body-insertable device 4480, and asystem 6120. The system includes a feature matching circuit 6124, whichis configured to determine a substantial correspondence between apresent-location landmark subsurface feature of a body part 210 of theindividual patient 205 (hereafter “individual patient body part”) and acandidate reference landmark subsurface feature of the individualpatient body part. The present-location landmark subsurface feature hasa first spatial relationship to a distal end portion of abody-insertable device deployed in the individual patient. The candidatereference landmark subsurface feature has a second spatial relationshipto a particular selected target region of interest of the individualpatient body part of at least two selected target regions of interest ofthe individual patient body part.

The system includes an event data circuit 6128 configured to generatedata indicative of a proximity event. The proximity event includes thedistal end portion of the body-insertable device being present at alocation proximate to the particular target region of interest of theindividual patient body part. The proximity event is at least partiallybased on the determined substantial correspondence. The system includesa list management circuit 6134 configured to add the proximity event toa proximity event list for the individual patient body part. The systemincludes a computer-readable media 235 configured to maintaininformational data corresponding to the proximity event list for theindividual patient body part. The system includes a communicationscircuit configured to output the informational data.

In an embodiment of the system 6120, the feature matching circuit 6124includes a feature matching circuit configured to determine asubstantial correspondence between a present-location landmarksubsurface feature of a cavity or lumen of an individual patient bodypart and a candidate reference landmark subsurface feature of the cavityor lumen of the individual patient body part. The present-locationlandmark subsurface feature has a first spatial relationship to a distalend portion of a body-insertable device deployed in the cavity or lumenof the individual patient. The candidate reference landmark subsurfacefeature has a second spatial relationship to a particular target regionof interest of the cavity or lumen of the individual patient body part.In an embodiment, the feature matching circuit includes a featurematching circuit configured to determine a substantial correspondencebetween a present-location landmark subsurface feature of a cavity orlumen of an individual patient body part and a candidate referencelandmark subsurface feature of the cavity or lumen of the individualpatient body part. The present-location landmark subsurface feature hasa first spatial relationship to a distal end portion of abody-insertable device deployed in the cavity or lumen of the individualpatient. The candidate reference landmark subsurface feature has asecond spatial relationship to a particular target region of interest ofa surface of the cavity or lumen of the individual patient body part

In an embodiment of the system 6120, the distal end portion 4483, of thebody-insertable device 4480 deployed in the individual patient 205includes an operative distal end portion of a body-insertable devicedeployed in the individual patient. In an embodiment of the system, thedistal end portion of a body-insertable device deployed in theindividual patient includes a moveable distal end portion of abody-insertable device deployed in the individual patient. In anembodiment, the distal end portion of a body-insertable device deployedin the individual patient includes an effector carried on a distal endportion of a body-insertable device deployed in the individual patient.

FIG. 103 illustrates a first spatial relationship between thepresent-location landmark subsurface feature, illustrated as thelandmark subsurface feature 5222, and the distal end portion 4483 of thebody-insertable device 4480 deployed in the body part 210 of theindividual patient, illustrated as the mammal 205. In an embodiment ofthe system 6120, the first spatial relationship includes a distance ofless than about six centimeters. In an embodiment of the system, thefirst spatial relationship includes a distance of less than about threecentimeters. In an embodiment of the system, the first spatialrelationship includes a distance of less than about one centimeter. Inan embodiment of the system, the first spatial relationship includes adistance of less than about fifty millimeters. In an embodiment, thefirst spatial relationship may include a bearing and distance.

Returning to FIG. 122, in an embodiment of the system 6120, thecandidate reference landmark subsurface feature of the individualpatient body part is selected from a patient examination table thatincludes the at least two reference landmark subsurface features of theindividual patient body part. Each candidate reference landmarksubsurface feature of the at least two candidate reference landmarksubsurface features has a respective spatial relationship to arespective particular selected target region of interest. The followingTable 1 illustrates an example patient examination table.

TABLE 1 PATIENT EXAMINATION TABLE Associated Target Regions ReferenceLandmark of Interest Subsurface Features 1 A 2 . . . 3 . . . 4 X 5 Y 6 Z

For example, the patient examination table may be prepared based upon avirtual colonoscopy performed on an individual patient. Certain regionsof the individual patient's colon may be selected from the virtualcolonoscopy as appropriate for further investigation. These regions aredescribed as “target regions of interest” in conjunction with thedescription of the system 6120. For example, the region of interest 5214described in conjunction with FIG. 103 may be selected as a targetregion of interest. In addition, certain landmark subsurface features ofthe patient's colon have respective spatial relationships to the targetregions of interest may also be selected from the virtual colonoscopy.These landmark subsurface features are described as “associatedreference landmark subsurface features” in conjunction with thedescription of the system 6120. For example, the landmark subsurfacefeature 5212 described in conjunction with FIG. 103 may be selected asthe associated reference landmark subsurface feature for the region ofinterest 5214. In another embodiment, the certain landmark subsurfacefeatures of the individual patient's colon have respective spatialrelationships to the target regions of interest may also be selectedfrom a generalized atlas of the mammalian body part 210, or a specificatlas of the individual patient's colon. For example, the atlas 5250described in conjunction with FIG. 103 may illustrate the generalizedatlas or the specific atlas of the individual patient's colon.

Continuing with FIG. 122, in an embodiment of the system 6120, thepatient examination table is at least partially based on a colonoscopyof the individual patient. In an embodiment, the patient examinationtable is at least partially based on a virtual colonoscopy of theindividual patient. In an embodiment, the patient examination table maybe at least partially based on another other suitable imaging technique,such as CAT scan, MRI, or ultrasound. In an embodiment, the patientexamination table is at least partially based on a subsurface featureatlas configured for the individual patient. In an embodiment, thepatient examination table is configured to facilitate an interestedparty to test, diagnose, or treat a possible medical condition of theindividual patient.

In an embodiment, the system 6120 includes a proximity indicator circuit6132 configured to generate a proximity indication if the first spatialrelationship is not greater than an operational reach of the distal endportion of the body-insertable device. For example, FIG. 103 illustratesthe distal end portion 4483 of a body-insertable device 4480 deployed inthe individual patient body part, indicated as mammalian body part 210.FIG. 103 illustrates an example where the first spatial relationship,illustrated by the spatial relationship 5226, is greater than theoperational reach, indicated by the dashed circle of operationallyproximate 4489, of the distal end portion of the body-insertable device.In FIG. 103, the operational reach of the distal end portion, such as aneffector or camera, illustrated the digital image acquisition device4481 and the active element 4482, indicated by the dashed circle ofoperationally proximate, is less than the first spatial relationship,illustrated by the spatial relationship 5226. In this event, theproximity indicator would not generate a proximity indication. Inanother example, which is not illustrated by FIG. 103, where the firstspatial relationship, such as illustrated by the spatial relationship5226, is not greater than the operational reach, indicated by the dashedcircle of operationally proximate 4489, of the distal end portion 4483of the body-insertable device, the proximity indicator will generate aproximity indication. For example, the operational reach may include adistance where an effector of the distal end portion is operable toresect or ablate tissue lying within the particular target region ofinterest.

Continuing with reference to FIG. 122, in an embodiment, the event datacircuit 6128 is configured to generate data indicative of a proximityevent. The proximity event includes the distal end portion of thebody-insertable device being present at a location that is operationallyproximate to the particular target region of interest of the individualpatient body part. The proximity event is at least partially based onthe determined substantial correspondence and on the proximityindication. For example, the proximity event may involve thebody-insertable device, or the proximity event may involve anotherdevice.

In an embodiment, the system 6120 includes a receiver circuit 6122configured to receive data indicative of an activity or action performedproximate to the present-location landmark subsurface feature. In anembodiment, the system 6120 includes the event data circuit 6128configured to (i) generate data indicative of a proximity event, and(ii) associate with the data indicative of a proximity event the dataindicative of an activity or action performed proximate to thepresent-location landmark subsurface feature. The proximity event is atleast partially based on the determined substantial correspondence andon the proximity indication. The proximity event includes the distal endportion of the body-insertable device present at a locationoperationally proximate to the particular target region of interest ofthe individual patient body part.

In an embodiment, the system 6120 includes a receiver circuit 6122 thatis configured to receive a first reference image that includes thepresent-location landmark subsurface of the individual patient bodypart. In an embodiment, the receiver circuit is configured to receive afirst reference image acquired by the body-insertable device deployed inthe individual patient and including the present-location landmarksubsurface of the individual patient body part. In an embodiment, thereceiver circuit is configured to receive a first reference imageacquired by an ex vivo device and including the present-locationlandmark subsurface of the individual patient body part. In anembodiment, the receiver circuit is configured to receive a firstreference image acquired by an ex vivo device and including thepresent-location landmark subsurface of the individual patient bodypart. In an embodiment, the receiver circuit is configured to receive asecond reference image that includes the candidate reference landmarksubsurface feature of the individual patient body part. In anembodiment, the receiver circuit is configured to receive from a localcomputer-readable media a second reference image that includes thecandidate reference landmark subsurface feature of the individualpatient body part. In an embodiment, the receiver circuit is configuredto receive from a remote computer-readable media via a network a secondreference image that includes the candidate reference landmarksubsurface feature of the individual patient body part. In anembodiment, the receiver circuit is configured to receive (i) a firstreference image that includes the present-location landmark subsurfaceof the individual patient body part, and (ii) a second reference imagethat includes the candidate reference landmark subsurface feature of theindividual patient body part.

In an embodiment, the system 6120 includes the communication circuit6142 that is configured to provide a notification that is at leastpartially based on the informational data to at least one of a human,computer, or system. In an embodiment, the system 6120 includes acommunication device configured to display a human-perceivable depictionof the proximity event list for the individual patient body part. Thecommunication device is illustrated by the computing device 292.

FIG. 103 illustrates an example of a use of an embodiment of the system6120. For example, the present location-landmark subsurface feature ofthe patient body part 210 may be illustrated by the landmark subsurfacefeature 5222 having the spatial relationship 5226 to the distal endportion 4483 of the body-insertable device 4480 deployed in theindividual patient 205. The candidate reference landmark subsurfacefeature may be illustrated as the landmark subsurface feature 5212having the spatial relationship 5216 to the region of interest 5214 ofthe individual patient body part. In such an example of an embodiment,the feature matching circuit 6124 would determine no substantialcorrespondence between the present location-landmark subsurface feature(illustrated as the landmark subsurface feature 5222) and the candidatereference landmark subsurface feature (illustrated as the landmarksubsurface feature 5212), so data indicative of a proximity event wouldnot be generated by the event data circuit 6128. However, in an exampleof an embodiment where the candidate reference landmark subsurfacefeature is illustrated by the landmark subsurface feature 5212, thefeature matching circuit 6124 would determine a substantialcorrespondence between the present-location landmark subsurface featureand the candidate reference landmark subsurface feature. Data indicativeof a proximity event would be generated by the event data circuit. Thelist management circuit 6134 would add this proximity event to aproximity event list for the individual patient body part. Informationaldata corresponding to the proximity event list for the individualpatient body part is maintained in the computer-readable media 235, andwould be outputted by the communication circuit 6142.

FIG. 123 illustrates an example operational flow 6200. The operationalflow includes a start operation. The operational flow includes amatching operation 6210. The matching operation includes determining asubstantial correspondence between (x) a present-location landmarksubsurface feature of a body part of an individual patient (hereafter“individual patient body part”) and (y) a candidate reference landmarksubsurface feature of the individual patient body part. Thepresent-location landmark subsurface feature has a first spatialrelationship to a distal end portion of a body-insertable devicedeployed in the individual patient. The candidate reference landmarksubsurface feature has a second spatial relationship to a particularselected target region of interest of the individual patient body partof at least two selected target regions of interest of the individualpatient body part. In an embodiment, the matching operation may beimplemented using the feature matching circuit 6124 described inconjunction with FIG. 122. A nearness operation 6220 includes generatinga proximity indication if the first spatial relationship is not greaterthan an operational reach of the distal end portion of thebody-insertable device. In an embodiment, the nearness operation may beimplemented using the proximity indicator circuit 6132 described inconjunction with FIG. 122. A reporting operation 6230 includesgenerating data indicative of a proximity event. The proximity eventincludes an instance where the distal end portion of the body-insertabledevice is present at a location operationally proximate to theparticular target region of interest of the individual patient bodypart. The proximity event is at least partially based on the determinedsubstantial correspondence and on the proximity indication. In anembodiment, the reporting operation may be implemented using event datacircuit 6128 described in conjunction with FIG. 122. A list managementoperation 6240 includes adding the proximity event to a proximity eventlist for the individual patient body part. In an embodiment, the listmanagement operation may be implemented using the list managementcircuit 6134 described in conjunction with FIG. 122. A communicationoperation 6250. The communication operation includes outputtinginformational data corresponding to the proximity event list for theindividual patient body part. In an embodiment, the communicationoperation may be implemented using the communication circuit 6142. Theoperational flow includes an end operation. In an alternativeembodiment, the operational flow includes a storage operation 6260 thatmaintaining the informational data in a computer-readable media. FIG.124 illustrates an alternative embodiment of the operational flow 6200of FIG. 123. In the alternative embodiment, the matching operation 6210may include at least one additional embodiment. The at least oneadditional embodiment may include an operation 6211, an operation 6212,or an operation 6213. The operation 6211 includes determining asubstantial correspondence between (x) a present-location landmarksubsurface feature of a cavity or lumen of an individual patient bodypart and (y) a candidate reference landmark subsurface feature of thecavity or lumen of the individual patient body part. Thepresent-location landmark subsurface feature has a first spatialrelationship to a distal end portion of a body-insertable devicedeployed in the cavity or lumen of the individual patient. The candidatereference landmark subsurface feature has a second spatial relationshipto a particular target region of interest of the cavity or lumen of theindividual patient body part. The operation 6212 includes determining asubstantial correspondence between (x) a present-location landmarksubsurface feature of a cavity or lumen of an individual patient bodypart and (y) a candidate reference landmark subsurface feature of thecavity or lumen of the individual patient body part. Thepresent-location landmark subsurface feature has a first spatialrelationship to a distal end portion of a body-insertable devicedeployed in the cavity or lumen of the individual patient. The candidatereference landmark subsurface feature has a second spatial relationshipto a particular target region of interest of a surface of the cavity orlumen of the individual patient body part. The operation 6213 includesdetermining a substantial correspondence between (x) a present-locationlandmark subsurface feature of a body part of an individual patient and(y) a candidate reference landmark subsurface feature of the individualpatient body part. The present-location landmark subsurface feature hasa first spatial relationship to a distal end portion of abody-insertable device deployed in the individual patient. The candidatereference landmark subsurface feature has a second spatial relationshipto a particular selected target region of interest of the individualpatient body part of at least two selected target regions of interest ofthe individual patient body part. The candidate reference landmarksubsurface feature is selected from a patient examination table thatincludes the at least two reference landmark subsurface features of theindividual patient body part. Each candidate reference landmarksubsurface feature of the at least two candidate reference landmarksubsurface features has a respective spatial relationship to arespective particular selected target region of interest.

FIG. 125 illustrates an alternative embodiment of the operational flow6200. The operational flow may include at least one additionaloperation, such as an operation 6270. The operation 6270 includesreceiving the patient examination table. The operation 6270 may includeat least one additional embodiment. The at least one additionalembodiment may include an operation 6271 or an operation 6272. Theoperation 6271 includes receiving the patient examination table from aremotely located computing device. The operation 6272 includes receivingthe patient examination table from a local computing device.

FIG. 126 illustrates an alternative embodiment of the operational flow6200. The operational flow may include at least one additionalembodiment. The at least one additional embodiment may include anoperation 6201, an operation 6203, or an operation 6205. The operation6201 includes receiving a first digital image that includes thepresent-location landmark subsurface of the individual patient bodypart. The operation 6203 includes a second digital image that includesthe candidate reference landmark subsurface feature of the individualpatient body part. The operation 6205 includes receiving data indicativeof an activity or action performed proximate to the present-locationlandmark subsurface feature.

FIG. 127 illustrates an alternative embodiment of the operational flow6200. The operational flow may include at least one additionalembodiment 6280. The at least one additional embodiment 6280 may includean operation 6282, an operation 6283, an operation 6284, an operation6285, or an operation 6286. The operation 6282 includes generating dataindicative of a proximity event. The proximity event includes the distalend portion of the body-insertable device present at a locationoperationally proximate to the particular target region of interest ofthe individual patient body part. The proximity event is at leastpartially based on the determined substantial correspondence and on theproximity indication. The operation 6282 also includes associating withthe data indicative of a proximity event the data indicative of anactivity or action performed proximate to the present-location landmarksubsurface feature. The operation 6283 includes providing a notificationat least partially based on the informational data to at least one of ahuman, computer, or system. The operation 6284 includes outputting asignal usable in displaying a human-perceivable depiction of theproximity event list for the individual patient body part. For example,the depiction may include an audio depiction, or a visual depiction ofthe proximity event list. For example, the depiction of the proximityevent list may include a depiction of a distance, or a depiction of anorientation. The operation 6285 includes transforming the informationaldata corresponding to the proximity event list for the individualpatient body part into data usable in displaying a particular visualindication of the proximity event list. The operation 6286 includesdisplaying a human-perceivable indication of the proximity event list.

FIG. 128 illustrates an example computer program product 6300. Thecomputer program product includes a computer-readable computer storagemedium 6310 bearing program instructions 6320. The program instructions,when executed by a processor of a computing device, cause the computingdevice to perform a process. The process includes determining asubstantial correspondence between (x) a present-location landmarksubsurface feature of a body part of an individual patient and (y) acandidate reference landmark subsurface feature of the individualpatient body part. The present-location landmark subsurface feature hasa first spatial relationship to a distal end portion of abody-insertable device deployed in the individual patient. The candidatereference landmark subsurface feature has a second spatial relationshipto a particular selected target region of interest of the individualpatient body part of at least two selected target regions of interest ofthe individual patient body part. The process includes generating aproximity indication if the first spatial relationship is not greaterthan an operational reach of the distal end portion of thebody-insertable device. The process includes generating data indicativeof a proximity event. The proximity event includes the distal endportion of the body-insertable device present at a locationoperationally proximate to the particular target region of interest ofthe individual patient body part. The proximity event is at leastpartially based on the determined substantial correspondence and on theproximity indication. The process includes adding the proximity event toa proximity event list for the individual patient body part. The processincludes storing in another computer-readable media operably coupledwith the processor informational data corresponding to the proximityevent list for the individual patient body part.

In an alternative embodiment of the program instructions 6320, thedetermining process includes 6322 determining a substantialcorrespondence between (x) a present-location landmark subsurfacefeature of a body part of an individual patient and (y) a candidatereference landmark subsurface feature of the individual patient bodypart. The present-location landmark subsurface feature has a firstspatial relationship to a distal end portion of a body-insertable devicedeployed in the individual patient. The candidate reference landmarksubsurface feature has a second spatial relationship to a particularselected target region of interest of the individual patient body partof at least two selected target regions of interest of the individualpatient body part. The candidate reference landmark subsurface featureis selected from a patient examination table that includes the at leasttwo reference landmark subsurface features of the individual patientbody part. Each candidate reference landmark subsurface feature of theat least two candidate reference landmark subsurface features has arespective spatial relationship to a respective particular selectedtarget region of interest.

In an embodiment, the computer-readable media 6310 includes a tangiblecomputer-readable media 6312. In an embodiment, the computer-readablemedia includes a communications medium 6314.

FIG. 129 illustrates an alternative embodiment of the programinstructions 6320. In an embodiment, the process further includes 6324receiving the patient examination table. In an embodiment, the processfurther includes 6326 outputting the informational data. The processfurther includes 6328 transforming the informational data into signalusable in providing a particular visual depiction of the proximity eventlist for the individual patient body part. The process further includes6332 providing a notification that is at least partially based on theinformational data to at least one of a human, computer, or system.

FIG. 130 illustrates an example system 6400. The system includes means6410 for determining a substantial correspondence between (x) apresent-location landmark subsurface feature of a body part of anindividual patient and (y) a candidate reference landmark subsurfacefeature of the individual patient body part. The present-locationlandmark subsurface feature has a first spatial relationship to a distalend portion of a body-insertable device deployed in the individualpatient. The candidate reference landmark subsurface feature has asecond spatial relationship to a particular selected target region ofinterest of the individual patient body part of at least two selectedtarget regions of interest of the individual patient body part. Thesystem includes means 6420 for generating data indicative of a proximityevent. The proximity event includes the distal end portion of thebody-insertable device present at a location operationally proximate tothe particular target region of interest of the individual patient bodypart. The proximity event is at least partially based on the determinedsubstantial correspondence. The system includes means 6430 for theproximity event to a proximity event list for the individual patientbody part. The system includes means 6440 for outputting theinformational data corresponding to the proximity event list for theindividual patient body part.

Returning to FIG. 122, FIG. 122 illustrates an alternative embodiment ofthe system 6120. The alternative embodiment of the system includes thereceiver circuit 6122 configured to receive (i) a first reference imagethat includes a present-location landmark subsurface feature of a bodypart of an individual patient (hereafter “individual patient bodypart”). The present-location landmark subsurface feature has a firstspatial relationship to a distal end portion of a body-insertable devicedeployed in the individual patient. The receiver circuit is alsoconfigured to receive a second reference image that includes a candidatereference landmark subsurface feature of the individual patient bodypart. The candidate reference landmark subsurface feature has a secondspatial relationship to a particular selected target region of interestof the individual patient body part of at least two selected targetregions of interest of the individual patient body part. The alternativeembodiment of the system includes the feature matching circuit 6124configured to determine a substantial correspondence between (x) thepresent-location landmark subsurface feature and (y) the candidatereference landmark subsurface feature. The alternative embodiment of thesystem includes the event data circuit 6128 configured to generate dataindicative of an occurrence of a proximity event. The occurrence of theproximity event includes the distal end portion of the body-insertabledevice being present at a location operationally proximate to theparticular target region of interest of the individual patient bodypart. The occurrence of the proximity event is at least partially basedon the determined substantial correspondence. The alternative embodimentof the system includes the list management circuit 6134 configured toadd the proximity event to a proximity event list for the individualpatient body part. The alternative embodiment of the system includes thecommunication circuit 6142 configured to output informational datacorresponding to the proximity event list.

In an embodiment of the alternative embodiment of the system 6120, thecandidate reference landmark subsurface feature of the individualpatient body part is selected from a patient examination table thatincludes the at least two reference landmark subsurface features of theindividual patient body part. Each candidate reference landmarksubsurface feature of the at least two candidate reference landmarksubsurface features has a respective spatial relationship to arespective particular selected target region of interest. In anembodiment of the alternative embodiment of the system, the patientexamination table is at least partially based on a virtual colonoscopyof the individual patient. In an embodiment of the alternativeembodiment of the system, the patient examination table is at leastpartially based on a subsurface feature atlas configured for theindividual patient. In an embodiment of the alternative embodiment ofthe system, the patient examination table is configured to facilitate aninterested party to test, diagnose, or treat a possible medicalcondition of the individual patient.

In an embodiment of the alternative embodiment of the system 6120, thereceiver circuit is configured to receive (i) a first reference imagethat includes a present-location landmark subsurface feature of a bodypart of an individual patient; (ii) a second reference image thatincludes a candidate reference landmark subsurface feature of theindividual patient body part; and (iii) activity data indicative of amedical activity or action performed by the body-insertable deviceproximate to the present-location landmark subsurface feature. Thepresent-location landmark subsurface feature has a first spatialrelationship to a distal end portion of a body-insertable devicedeployed in the individual patient. The candidate reference landmarksubsurface feature has a second spatial relationship to a particularselected target region of interest of the individual patient body partof at least two selected target regions of interest of the individualpatient body part. The activity data may be acquired by thebody-insertable device 4480, by another device, such as the ex vivodevice 290, an activity data generator circuit [not illustrated], or bya user illustrated as the person 296, such as a health care provider,entering the activity data using the computing device 292 for directreception by the receiver circuit 6122 or for reception by the activitydata generator for processing and provision to the receiver circuit. Forexample, the activity data may include activity data indicative of anactivity or action performed by the distal end portion of thebody-insertable device while located operationally proximate to thepresent-location landmark subsurface feature. For example, the activitydata may include activity data indicative of an activity or actionperformed by a device other than the body-insertable device whilelocated operationally proximate to the present-location landmarksubsurface feature. For example, the activity data may include activitydata indicative of a therapeutic activity or action performed proximateto the present-location landmark subsurface feature. For example, theactivity data may include activity data indicative of a treatmentactivity or action performed proximate to the present-location landmarksubsurface feature. For example, the activity data may include activitydata indicative of a maneuvering by the distal end portion of thebody-insertable device while located operationally proximate to thepresent-location landmark subsurface feature. For example, the activitydata may include activity data indicative of an activity or actionperformed proximate to the present-location landmark subsurface feature,the data includes a time stamp. For example, a time stamp may include asequence of characters denoting the date and/or time at which theactivity or action was performed. For example, the activity data mayinclude activity data indicative of an absence of an activity or actionby the distal end portion of the body-insertable device while locatedoperationally proximate to the present-location landmark subsurfacefeature.

In an embodiment of the alternative embodiment of the system 6120, theevent data circuit 6128 includes an event data circuit configured togenerate data indicative of an occurrence of a proximity event. Theoccurrence of the proximity event includes the distal end portion of thebody-insertable device being present at a location operationallyproximate to the particular target region of interest of the individualpatient body part. The occurrence of the proximity event is at leastpartially based on (i) the determined substantial correspondence, (ii)the proximity indication, and (iii) the activity data.

In an embodiment of the alternative embodiment of the system 6120, thereceiver circuit 6122 is further configured to receive a patientexamination table that includes at least two reference landmarksubsurface features of the individual patient body part. Each referencelandmark subsurface feature of the at least two reference landmarksubsurface features has a respective spatial relationship to arespective particular target region of interest.

In an embodiment of the alternative embodiment of the system 6120, thesystem includes the proximity indicator circuit 6132 configured togenerate a proximity indication if the first spatial relationship is notgreater than an operational reach of the distal end portion of thebody-insertable device. In an embodiment of the alternative embodimentof the system, the event data circuit 6128 is configured to generatedata indicative of an occurrence of a proximity event. The occurrence ofthe proximity event includes the distal end portion of thebody-insertable device being present at a location operationallyproximate to the particular target region of interest of the individualpatient body part. The occurrence of the proximity event is at leastpartially based on the determined substantial correspondence and on theproximity indication.

FIG. 131 illustrates an example operational flow 6500. The operationalflow includes a start operation. The operational flow includes a firstreception operation 6510. The first reception operation includesreceiving a first reference image that includes a present-locationlandmark subsurface feature of a body part of an individual patient(hereafter “individual patient body part”). The present-locationlandmark subsurface feature has a first spatial relationship to a distalend portion of a body-insertable device deployed in the individualpatient. A second reception operation 6520 includes receiving a secondreference image that includes a candidate reference landmark subsurfacefeature of the individual patient body part. The candidate referencelandmark subsurface feature has a second spatial relationship to aparticular selected target region of interest of the individual patientbody part of at least two selected target regions of interest of theindividual patient body part. In an embodiment, the first receptionoperation or the second reception operation may be implemented using thereceiver circuit 6122 described in conjunction with FIG. 121. A nearnessoperation 6530 includes generating a proximity indication if the firstspatial relationship is not greater than an operational reach of thedistal end portion of the body-insertable device. In an embodiment, thenearness operation may be implemented using the proximity indicatorcircuit 6132 described in conjunction with FIG. 122. A matchingoperation 6540 includes determining a substantial correspondence between(x) the present-location landmark subsurface feature and (y) thecandidate reference landmark subsurface feature. In an embodiment, thematching operation may be implemented using the feature matching circuit6124 described in conjunction with FIG. 122. A reporting operation 6550includes generating data indicative of an occurrence of a proximityevent. The occurrence of the proximity event includes the distal endportion of the body-insertable device being present at a locationoperationally proximate to the particular target region of interest ofthe individual patient body part. The occurrence of the proximity eventis at least partially based on the determined substantial correspondenceand on the proximity indication. In an embodiment, the reportingoperation may be implemented using the event data circuit 6128 describedin conjunction with FIG. 122. A list management operation 6560 includesadding the occurrence of the proximity event to a proximity event listfor the individual patient body part. In an embodiment, the listmanagement operation may be implemented using the list managementcircuit 6134 described in conjunction with FIG. 122. A communicationoperation 6570 includes outputting informational data corresponding tothe proximity event list. In an embodiment, the communication operationmay be implemented using the communication circuit 6142 described inconjunction with FIG. 122. The operational flow includes an endoperation.

FIG. 132 illustrates an alternative embodiment of the operational flow6500 of FIG. 131. The operational flow may include at least oneadditional operation, such as an operation 6502. The operation 6502includes receiving activity data indicative of a medical activity oraction performed by the body-insertable device proximate to thepresent-location landmark subsurface feature. In an embodiment, thereporting operation 6550 may include at least one additional operation,such as an operation 6552. The operation 6552 includes generating dataindicative of an occurrence of a proximity event. The occurrence of theproximity event includes the distal end portion of the body-insertabledevice being present at a location operationally proximate to theparticular target region of interest of the individual patient bodypart. The occurrence of the proximity event is at least partially basedon (i) the determined substantial correspondence, (ii) the proximityindication, and (iii) the activity data.

In an embodiment, the candidate reference landmark subsurface feature ofthe individual patient body part is selected from a patient examinationtable that includes the at least two reference landmark subsurfacefeatures of the individual patient body part, each candidate referencelandmark subsurface feature of the at least two candidate referencelandmark subsurface features having a respective spatial relationship toa respective particular selected target region of interest. In anembodiment, the patient examination table is at least partially based ona virtual colonoscopy of the individual patient. In an embodiment, thepatient examination table is at least partially based on a subsurfacefeature atlas configured for the individual patient. In an embodiment,the patient examination table is configured to facilitate an interestedparty to test, diagnose, or treat a possible medical condition of theindividual patient.

FIG. 133 illustrates an example computer program product 6600. Thecomputer program product includes a computer-readable computer storagemedium 6610 bearing program instructions 6620. The program instructions,when executed by a processor of a computing device, cause the computingdevice to perform a process. The process includes receiving a firstreference image that includes a present-location landmark subsurfacefeature of a body part of an individual patient. The present-locationlandmark subsurface feature has a first spatial relationship to a distalend portion of a body-insertable device deployed in the individualpatient. The process includes receiving a second reference image thatincludes a candidate reference landmark subsurface feature of theindividual patient body part. The candidate reference landmarksubsurface feature has a second spatial relationship to a particularselected target region of interest of the individual patient body partof at least two selected target regions of interest of the individualpatient body part. The process includes generating a proximityindication if the first spatial relationship is not greater than anoperational reach of the distal end portion of the body-insertabledevice. The process includes determining a substantial correspondencebetween (x) present-location landmark subsurface feature and (y) thecandidate reference landmark subsurface feature. The process includesgenerating data indicative of an occurrence of a proximity event. Theoccurrence of the proximity event includes the distal end portion of thebody-insertable device being present at a location operationallyproximate to the particular target region of interest of the individualpatient body part. The occurrence of the proximity event is at leastpartially based on the determined substantial correspondence and on theproximity indication. The process includes adding the proximity event toa proximity event list for the individual patient body part. The processincludes outputting informational data corresponding to the proximityevent list.

FIG. 134 illustrates an example environment 6700. The environmentincludes the mammalian body part 210 of a known patient, illustrated asa mammal 6705, a person presenting 6707, and a system 6720. For exampleand without limitation, the system uses a distinctive landmarksubsurface feature of a body part of a known patient to verify that aperson presenting themselves for treatment or health care is the knownpatient. The system includes a receiver circuit 6722 configured toreceive a first reference image that includes a representation of adistinctive landmark subsurface feature of a body part of a knownpatient. The first reference image was acquired by the body-insertabledevice 280 deployed in a body part 210 of the known patient. Forexample, a known patient includes one who has previously received orrequested medical treatment. For example, the distinctive landmarksubsurface feature may include a physical structure, nerve, void,border, component, tissue, structural feature, or density variation ofthe body part. For example, the physical structure may include a duct, abend or curve in a tubular structure, or an organ such as a colon. Forexample, a distinctive landmark subsurface feature may include alandmark subsurface unique to the known patient, much like a fingerprint is considered unique to a person. For example, a distinctivelandmark subsurface feature may include a landmark subsurface thatoccurs infrequently or rarely, such a degree of distinctiveness as maybe necessary to impart a reasonable degree of confidence as a usefultool in distinguishing between persons likely to present themselves.

The receiver circuit 6722 is also configured to receive a secondreference image that includes a representation of a contemporaneouslyacquired landmark subsurface feature of a body part of a personpresenting. The second reference image was acquired by anotherbody-insertable device deployed in a body part of the person presenting.The body part of the known patient and the body part of the personpresenting are the same kind of body part. For example, the kind of bodypart of the known patient and the person presenting may be the colon.For example, the kind of body part of the known patient and the personpresenting may be the stomach. For example, a contemporaneously acquiredlandmark subsurface feature may include a landmark subsurface featureacquired when a patient presents themselves to a heath care provider orfacility at an appointed time for treatment or diagnosis.

The system 6720 includes a feature matching circuit 6724 configured todetermine a substantial correspondence between (x) the distinctivelandmark subsurface feature of a body part of a known patient and (y)the contemporaneously-acquired landmark subsurface feature of a bodypart of a person presenting. The system includes a data circuit 6728 isconfigured to generate informational data indicative of a verificationof the person presenting with respect to the known patient. Theverification is at least partially based on the determined substantialcorrespondence between the distinctive landmark subsurface feature andthe contemporaneously-acquired landmark subsurface feature. For example,the system treats a determination of a substantial correspondence as anindication that the distinctive landmark subsurface feature and thecontemporaneously-acquired landmark subsurface feature are the samelandmark subsurface feature, and infers that the person presenting isthe known patient. If a substantial correspondence is determined, thesystem generates informational data indicative of a verification of theperson presenting with respect to the known patient. The system includesa communications circuit 6742 configured to output the informationaldata corresponding to the verification of the person presenting withrespect to the known patient. The informational data may be presented tothe health care provider or their staff for use in deciding whether totreat the person presenting.

In an embodiment, the reference landmark subsurface feature includes areference landmark subsurface feature of the cavity or lumen 211 of thebody part 210 of the known patient 6705. In an embodiment, the referencelandmark subsurface feature includes a reference landmark subsurfacefeature of a body part of a known patient designated for an evaluation,test, diagnosis, or treatment of a possible medical condition. In anembodiment, the known patient includes a patient scheduled or expectedfor an evaluation, test, diagnosis, or treatment of a possible medicalcondition. For example, a known patient may include a patient scheduledfor removal of a polyp from their colon. In an embodiment, thecontemporaneously acquired landmark subsurface feature of a body part ofa person presenting 6707 themselves for the evaluation, test, diagnosis,or treatment of a possible medical condition. In an embodiment, thereference landmark subsurface feature includes a reference landmarksubsurface feature of a body part of a known patient, and acquired froman electronically maintained record of the known patient. In anembodiment, the reference landmark subsurface feature includes areference landmark subsurface feature of a body part of a known patient,and acquired from an electronically maintained landmark subsurfacefeature library of the known patient. In an embodiment, the referencelandmark subsurface feature includes a reference landmark subsurfacefeature of a body part of a known patient, and acquired from anelectronically maintained landmark subsurface feature atlas of the knownpatient. In an embodiment, the reference landmark subsurface featureincludes a reference landmark subsurface feature included in a digitalimage of a body part of a known patient. In an embodiment, the referencelandmark subsurface feature includes a reference landmark subsurfacefeature of a body part of a known patient included in a digital imageacquired by a body-insertable device has a portion deployed in thecavity or lumen of the body part of the known patient.

In an embodiment, the contemporaneously acquired landmark subsurfacefeature includes a contemporaneously acquired landmark subsurfacefeature of the body part 210 of a person currently presenting 6707. Inan embodiment, the contemporaneously acquired landmark subsurfacefeature includes a contemporaneously acquired landmark subsurfacefeature of a body part of a person currently presenting themselves foran evaluation, test, diagnosis, or treatment of a possible medicalcondition. In an embodiment, the contemporaneously acquired landmarksubsurface feature includes a contemporaneously acquired landmarksubsurface feature of a body part of a person presenting themselves asthe known patient. In an embodiment, the contemporaneously acquiredlandmark subsurface feature includes a contemporaneously acquiredlandmark subsurface feature of a body part of a person presenting andincluded in digital image. In an embodiment, the contemporaneouslyacquired landmark subsurface feature includes a contemporaneouslyacquired landmark subsurface feature of a body part of a personpresenting and included in digital image acquired by a body-insertabledevice has a portion deployed in a cavity or lumen of the body part ofthe person presenting. In an embodiment, the contemporaneously acquiredlandmark subsurface feature includes a contemporaneously acquiredlandmark subsurface feature of a body part of a person presenting andincluded in digital image acquired by an ex vivo device.

In an embodiment, the first reference image was acquired by abody-insertable device deployed in a cavity or lumen of a body part ofthe known patient 6705. In an embodiment, the second reference image isacquired by another body-insertable device deployed in a cavity or lumenof a body part of the person presenting 6707. In an embodiment, thedistinctive landmark subsurface feature includes a distinctive landmarksubsurface feature of a cavity or lumen of a body part of a knownpatient. In an embodiment, the contemporaneously acquired landmarksubsurface feature includes a contemporaneously acquired landmarksubsurface feature of a cavity or lumen of a body part of a personpresenting. In an embodiment, the distinctive landmark subsurfacefeature includes a distinctive landmark subsurface feature of a bodypart of a known patient designated for an evaluation, test, diagnosis,or treatment of a possible medical condition. For example, the knownpatient may be scheduled or expected for a medical procedure. In anembodiment, the contemporaneously-acquired landmark subsurface featureincludes a contemporaneously-acquired landmark subsurface feature of abody part of a person presenting themselves for the evaluation, test,diagnosis, or treatment of a possible medical condition. In anembodiment, the distinctive landmark subsurface feature includes adistinctive landmark subsurface feature of a body part of a knownpatient. The distinctive landmark subsurface feature acquired by thesystem from an electronically maintained record of the known patient. Inan embodiment, the distinctive landmark subsurface feature includes adistinctive landmark subsurface feature of a body part of a knownpatient, and acquired by the system from an electronically maintainedlandmark subsurface feature atlas. In an embodiment, thecontemporaneously-acquired landmark subsurface feature includes acontemporaneously-acquired landmark subsurface feature of a body part ofa person currently presenting for an evaluation, test, diagnosis, ortreatment of a possible medical condition. In an embodiment, thecontemporaneously-acquired landmark subsurface feature includes acontemporaneously-acquired landmark subsurface feature of a body part ofa person presenting themselves as the known patient.

In an embodiment, the data circuit 6728 is configured to generateinformational data indicative of a patient verification. The patientverification includes a verification of the person presenting 6707 withrespect to the known patient 6705. The patient verification is at leastpartially based on the determined substantial correspondence between thereference landmark subsurface feature and the contemporaneously acquiredlandmark subsurface feature. Otherwise, the data circuit is configuredto generate informational data indicative of an absence of averification of the person presenting with respect to the known patient.The absence of a verification is at least partially based on an absenceof a determined substantial correspondence between the referencelandmark subsurface feature and the contemporaneously acquired landmarksubsurface feature. In an embodiment, the communications circuit 6742 isconfigured to output the informational data indicative of a verificationof the person presenting with respect to the known patient, or to outputthe informational data indicative of an absence of a verification of theperson presenting with respect to the known patient. The notificationcorresponding to the verification of the person presenting 6707 withrespect to the known patient 6705.

In an embodiment, the communication circuit 6742 includes acommunication circuit configured to provide a notification that is atleast partially based on the informational data to at least one of ahuman, computer, or system. In an embodiment, the system 6720 includes acomputer-readable media 235 configured to maintain the informationaldata. In an embodiment, the system 6720 includes communication device292 configured to display a human-perceivable depiction of theinformational data.

In an embodiment, the body-insertable device 280 and the anotherbody-insertable device are substantially the same type ofbody-insertable device. In an embodiment, the body-insertable device andthe another body-insertable device are a substantially different type ofbody-insertable device.

FIG. 135 illustrates an example operational flow 6800. The operationalflow includes a start operation. The operational flow includes a firstreception operation 6810. The first reception operation includesreceiving a first reference image that includes a representation of adistinctive landmark subsurface feature of a body part of a knownpatient. The first reference image is acquired by a body-insertabledevice deployed in a body part of the known patient. A second receptionoperation 6820 includes receiving a second reference image that includesa representation of a contemporaneously acquired landmark subsurfacefeature of a body part of a person presenting. The second referenceimage is acquired by another body-insertable device deployed in a bodypart of the person presenting. The body part of the known patient andthe body part of the person presenting being the same kind of body part.In an embodiment, the first reception operation or the second receptionoperation may be implemented using the receiver circuit 6722 describedin conjunction with FIG. 134. A matching operation 6830 includesdetermining a substantial correspondence between (x) the distinctivelandmark subsurface feature of a body part of a known patient and (y)the contemporaneously-acquired landmark subsurface feature of a bodypart of a person presenting. In an embodiment, the matching operationmay be implemented using the feature matching circuit described inconjunction with FIG. 134. A patient verification operation 6840includes generating informational data indicative of a verification ofthe person presenting with respect to the known patient. The patientverification is at least partially based on the determined substantialcorrespondence between the distinctive landmark subsurface feature andthe contemporaneously-acquired landmark subsurface feature. In anembodiment, the verification operation may be implemented using the datacircuit 6728 described in conjunction with FIG. 134. A communicationoperation 6850 includes outputting the informational data. Thecommunication operation may be implemented using the communicationcircuit 6742 described in conjunction with FIG. 134. The operationalflow includes an end operation.

FIG. 136 illustrates an alternative embodiment of the operational flow6800 of FIG. 135. In an embodiment, the patient verification operation6830 may include at least one additional embodiment. The at least oneadditional embodiment may include an operation 6832 or an operation6834. The operation 6832 includes determining a substantialcorrespondence between (x) the distinctive landmark subsurface featureof a cavity or lumen of a body part of a known patient and (y) thecontemporaneously-acquired landmark subsurface feature of a cavity orlumen of a body part of a person presenting. The operation 6834 includesdetermining a substantial correspondence between (x) the distinctivelandmark subsurface feature of a body part of a known patient who isdesignated for an evaluation, test, diagnosis, or treatment of apossible medical condition and (y) the contemporaneously acquiredlandmark subsurface feature of a body part of a person presenting forthe evaluation, test, diagnosis, or treatment of a possible medicalcondition.

FIG. 137 illustrates an alternative embodiment of the operational flow6800 of FIG. 135. In an embodiment, the patient verification operation6840 may include at least one additional operation, such as include anoperation 6842. The operation 6842 includes generating informationaldata indicative of a verification of the person presenting with respectto the known patient; the verification is at least partially based onthe determined substantial correspondence between the reference landmarksubsurface feature and the contemporaneously acquired landmarksubsurface feature—otherwise, generating informational data indicativeof an absence of a verification of the person presenting with respect tothe known patient; the absence of a verification is at least partiallybased on an absence of a determined substantial correspondence betweenthe reference landmark subsurface feature and the contemporaneouslyacquired landmark subsurface feature. In this alternative embodiment,the communication operation 6850 may include at least one additionaloperation, such as an operation 6852. The operation 6852 includesoutputting the informational data indicative of a verification of theperson presenting with respect to the known patient, or outputting theinformational data indicative of an absence of a verification of theperson presenting with respect to the known patient.

FIG. 138 illustrates an alternative embodiment of the operational flow6800 of FIG. 135. In an embodiment, the operational flow 6800 mayinclude at least one additional operation. The at least one additionaloperation is illustrated as operation 6860. The operation 6860 mayinclude an operation 6862, an operation 6864, an operation 6866, or anoperation 6868. The operation 6862 includes saving the informationaldata in a computer-readable media. The 6864 includes providing anotification that is at least partially based on the informational datato at least one of a human, computer, or system. The operation 6866includes outputting a signal usable in displaying a human-perceivabledepiction of the verification of the person presenting with respect tothe known patient. The operation 6868 includes transforming theinformational data into a particular visual depiction of theverification of the person presenting with respect to the known patient.

FIG. 139 illustrates a computer program product 6900. The computerprogram product includes a computer-readable media 6910 bearing theprogram instructions 6920. The program instructions, when executed by aprocessor of a computing device, cause the computing device to perform aprocess. The process includes receiving a first reference image thatincludes a representation of a distinctive landmark subsurface featureof a body part of a known patient. The first reference image wasacquired by a body-insertable device deployed in a body part of theknown patient. The process includes receiving a second reference imagethat includes a representation of a contemporaneously acquired landmarksubsurface feature of a body part of a person presenting. The secondreference image was acquired by another body-insertable device deployedin a body part of the person presenting, the body part of the knownpatient and the body part of the person presenting being the same kindof body part. The process includes determining a substantialcorrespondence between (x) the distinctive landmark subsurface featureof a body part of a known patient and (y) the contemporaneously-acquiredlandmark subsurface feature of a body part of a person presenting. Theprocess includes generating informational data indicative of averification of the person presenting with respect to the known patient.The verification is at least partially based on the determinedsubstantial correspondence between the distinctive landmark subsurfacefeature and the contemporaneously-acquired landmark subsurface feature.The process includes outputting the informational data.

In an embodiment, the process of generating informational data includes6922 generating informational data indicative of a verification of theperson presenting with respect to the known patient; the verification isat least partially based on the determined substantial correspondencebetween the reference landmark subsurface feature and thecontemporaneously acquired landmark subsurface feature—otherwise,generating informational data indicative of an absence of a verificationof the person presenting with respect to the known patient, the absenceof a verification is at least partially based on an absence of adetermined substantial correspondence between the reference landmarksubsurface feature and the contemporaneously acquired landmarksubsurface feature. In this embodiment, the process of outputting theinformational data may include 6924 outputting the informational dataindicative of a verification of the person presenting with respect tothe known patient, or outputting the informational data indicative of anabsence of a verification of the person presenting with respect to theknown patient.

In an embodiment, the program instructions 6920 may cause the computingdevice to perform an additional process. The additional process mayinclude a process 6932, a process 6934, a process 6936, or a process6938. The process 6932 includes providing a notification that is atleast partially based on the informational data to at least one of ahuman, computer, or system. The process 6934 includes outputting asignal usable in displaying a human-perceivable depiction of theverification of the person presenting with respect to the known patient.The process 6936 includes transforming the informational data into asignal usable in displaying a particular visual depiction of theverification of the person presenting with respect to the known patient.The process 6938 includes storing in another computer-readable mediaoperably coupled with the processor informational data corresponding tothe verification of the person presenting with respect to the knownpatient.

In an embodiment, the computer-readable media 6910 includes a tangiblecomputer-readable media 6912. In an embodiment, the computer-readablemedia includes a communications media 6914.

FIG. 140 illustrates an example system 7000. The system includes means7010 for receiving a first reference image that includes arepresentation of a distinctive landmark subsurface feature of a bodypart of a known patient. The first reference image was acquired by abody-insertable device deployed in a body part of the known patient. Thesystem includes means 7020 for receiving a second reference image thatincludes a representation of a contemporaneously acquired landmarksubsurface feature of a body part of a person presenting. The secondreference image was acquired by another body-insertable device deployedin a body part of the person presenting. The body part of the knownpatient and the body part of the person presenting being the same kindof body part. The system includes means 7030 for determining asubstantial correspondence between (x) the distinctive landmarksubsurface feature of a body part of a known patient and (y) thecontemporaneously acquired landmark subsurface feature of a body part ofa person presenting. The system includes means 7040 for generatinginformational data indicative of a verification of the person presentingwith respect to the known patient. The verification is at leastpartially based on the determined substantial correspondence between thedistinctive landmark subsurface feature and thecontemporaneously-acquired landmark subsurface feature. The systemincludes means 7050 for outputting the informational data.

FIG. 141 illustrates an example environment 7100. The environmentincludes the mammalian body part 210 of the mammal 205, and a system7120. The system includes a receiver circuit 7122 configured to receiveat least two reference images of a patient body part. Each referenceimage of the at least two reference images includes a respectivelandmark subsurface feature of the patient body part (hereafter “imagedlandmark subsurface feature”). Each imaged landmark subsurface featurehas a respective spatial relationship to a respective region of asurface of the patient body part imaged during a medical examination(hereafter “imaged region”). The system includes a feature matchingcircuit 7124 configured to determine a correspondence between (x) eachatlas landmark subsurface feature of the patient body part of at leasttwo atlas landmark subsurface features of the patient body part includedin a landmark subsurface feature atlas and (y) each respective imagedlandmark subsurface feature of the patient body part included in the atleast two reference images. For example, the subsurface feature atlasmay be substantially similar to a generated subsurface feature atlas,such as the subsurface feature atlas generated by the atlas generationcircuit 3028 described in conjunction with FIG. 67, or generated by theprocess 3224 described in conjunction with FIG. 73 or by the mappingoperation 3950 described in conjunction with FIG. 81. For example, thesubsurface feature atlas may be a generally published atlas of the bodypart.

The system 7120 includes a reporting circuit 7126 configured to generateinformational data reporting a depiction of an area of the surface ofthe patient body part by at least two adjacent imaged regions of thesurface of the patient body part, the informational data is at leastpartially based on the determined correspondence. The system includes acommunication circuit 7142 configured to output the informational data.For example, the determined correspondence may include a determinedpositive correspondence, a negative correspondence, or an absence of adetermined positive correspondence.

FIG. 142 illustrates an example environment 7200 in which an embodimentof the system 7120 of FIG. 141 may be used. The example environmentincludes at least two reference images 7210 of a patient body part. Theat least two reference images 7210 are illustrated as reference images7210.1, 7210.2, and 7210.3. The reference images may be acquired duringa course of an examination of the patient body part of a patient. Eachreference image of the at least two reference images includes arespective landmark subsurface feature 7212 of the patient body part(hereafter “imaged landmark subsurface feature”) has a spatialrelationship to a respective imaged region of a surface of the patientbody part. The respective imaged landmark subsurface features of thepatient body part are illustrated as imaged landmark subsurface featuresof the patient body parts 7212.1, 7212.2, and 7212.3 of the referenceimages 7210.1, 7210.2, and 7210.3. The imaged landmark subsurfacefeatures of the patient body parts 7212.1, 7212.2, and 7212.3 haverespective spatial relationships 7230.1, 7230.2, and 7230.3 with imagedregions 7222.1, 7222.2, and 7222.3 of the surface of the patient bodypart 210 (not shown). In an embodiment, the imaged regions 7222.1,7222.2, and 7222.3 may be respectively included in reference images7220.1, 7220.2, and 7220.3. In an embodiment, the imaged landmarksubsurface features of the patient body part 7212.1, 7212.2, and 7212.3having the spatial relationships 7230.1, 7230.2, and 7230.3 with imagedregions 7222.1, 7222.2, and 7222.3 of the surface of the patient bodypart may be respectively included in comprehensive reference images7240.1, 7240.2, and 7240.3.

The example environment 7200 illustrates an embodiment of an examplesubsurface feature atlas 7250 of the patient body part 210 (notillustrated). The example subsurface feature atlas 7250 includesregistered atlas subsurface features A through Z, illustrated as atlassubsurface features 7272A through 7272D, and atlas subsurface features7272X through 7272Z. In an embodiment, the subsurface feature atlasindicates the registration of the atlas subsurface features. Theregistration is indicated by the respective spatial relationshipsillustrated between the at least two atlas subsurface features. Forexample, the subsurface feature atlas illustrates a spatial relationshipbetween the atlas subsurface feature 7272X and the atlas subsurfacefeature 7272Z as a spatial relationship 7254XZ.

An example of an operation of an embodiment of the system 7120 may beillustrated using FIG. 142. For example, a health care providerillustrated as the person 296 may be conducting a colon examination andtaking medical images that include regions of the surface of the colon(imaged regions) that are medically interesting. The health careprovider may want informational data indicating which portions of thecolon are included in the imaged regions, or whether they have takenmedical images across a portion of the surface of the colon, or theentire surface of the colon. Alternatively, the health care provider maybe taking reference images of surgical procedure sites of a surface of acolon, such as removing polyps. In this case, the health care providermay want informational data indicating which regions of the colon willbe or have been the subject of surgical procedures, or if they havemissed any regions.

In this example of a use of an embodiment of the system 7120, thereceiver circuit 7122 receives the at least two reference images 7210 ofthe patient body part, which are illustrated as the reference images7210.1, 7210.2, and 7210.3. As described above, the reference images7210.1, 7210.2, and 7210.3 include the imaged landmark subsurfacefeatures of the patient body part 7212.1, 7212.2, and 7212.3 having thespatial relationships 7230.1, 7230.2, and 7230.3 with imaged regions7222.1, 7222.2, and 7222.3 of the surface of the patient body part. Thefeature matching circuit 7124 determines a correspondence between anatlas landmark subsurface feature and an imaged landmark subsurfacefeature of the patient body part. For example, the feature matchingcircuit will determine a correspondence between the atlas landmarksubsurface feature 7272A and the imaged landmark subsurface feature7212.1. As can be seen from FIG. 142, the feature matching circuit willfind a negative or no correspondence between the atlas landmarksubsurface feature 7272A and the imaged landmark subsurface feature7212.1, which may be indicated by outputting a “0”. The feature matchingcircuit will determine a correspondence between the atlas landmarksubsurface feature 7272B and the imaged landmark subsurface feature7212.1. As can be seen from FIG. 142, the feature matching circuit willindicate a positive correspondence between the atlas landmark subsurfacefeature 7272B and the imaged landmark subsurface feature 7212.1, whichmay be indicated by a “1”. The correspondence determination continuesfor the remaining the atlas landmark subsurface features, which as canbe seen from FIG. 142, the feature matching circuit will find a negativecorrespondence, which may be indicated by outputting a “0” for each ofthe remaining atlas landmark subsurface features. The feature matchingcircuit may proceed iteratively through a selected portion of thesubsurface feature atlas, or through the entire subsurface feature atlasdetermining correspondences. In an embodiment, the feature matchingcircuit may perform its operations in any manner that determines acorrespondence between a selected range of the atlas landmark subsurfacefeatures and a selected range of the landmark subsurface features. Forexample, the feature matching circuit proceeds iteratively through thelandmark subsurface features determining correspondences with the atlaslandmark subsurface features, or may proceed iteratively through theatlas landmark subsurface features determining correspondences with thelandmark subsurface features.

In this example of a use of an embodiment of the system 7120, the reportcircuit 7126 generates informational data that is at least partiallybased on the determined correspondence for at least one atlas landmarksubsurface feature of the at least two atlas landmark subsurfacefeatures included in the subsurface feature atlas 7250. For example, thereport circuit may generate informational data indicating one positivecorrespondence between the atlas landmark subsurface feature 7272B andthe imaged landmark subsurface feature 7212.1. Such informational datawhen communicated to the health care provider may inform them they haveimaged the region of the surface of the patient body part spatiallyrelated 7230.1 to atlas landmark subsurface feature 7272B. In anotherexample, the report circuit may generate informational data indicatingall negative correspondences for atlas landmark subsurface feature7272C. Such informational data when communicated to the health careprovider may inform them they have not imaged the region of the surfaceof the patient body part spatially related to atlas landmark subsurfacefeature 7272C.

In this example of a use of an embodiment of the system 7120, thecommunication circuit 7142 outputs the informational data. In anembodiment, the informational data may be displayed on the screen 294 ofthe computing device 292 to the person 296, as described in conjunctionwith FIG. 3. In an embodiment, the informational data may be displayedon a screen associated with the system 7120 (not shown).

Returning to FIG. 141, in an embodiment of the system 7120, the at leasttwo reference images include at least two reference images of a patientbody part having a cavity or lumen, each reference image of the at leasttwo reference images includes a respective landmark subsurface featureof the patient body part. Each imaged landmark subsurface feature has arespective spatial relationship to a respective region of a surface ofthe cavity or lumen of the patient body part imaged during a medicalexamination. In an embodiment, the at least two reference imagesincludes at least two reference images of a patient body part acquiredby an ex vivo device. Each reference image of the at least two referenceimages includes a respective landmark subsurface feature of the patientbody part. Each imaged landmark subsurface feature has a respectivespatial relationship to a respective region of a surface of the patientbody part imaged during a medical examination.

In an embodiment, each imaged landmark subsurface feature has arespective spatial relationship of less than about six centimeters to arespective region of a surface of the patient body part imaged during amedical examination. In an embodiment, each imaged landmark subsurfacefeature has a respective spatial relationship of less than about threecentimeters to a respective region of a surface of the patient body partimaged during a medical examination. In an embodiment, each imagedlandmark subsurface feature has a respective spatial relationship ofless than about one centimeter to a respective region of a surface ofthe patient body part imaged during a medical examination. In anembodiment, each imaged landmark subsurface feature has a respectivespatial relationship of less than about fifty millimeters to arespective region of a surface of the patient body part imaged during amedical examination. In an embodiment, each imaged landmark subsurfacefeature has a respective spatial relationship of less than abouttwenty-five millimeters to a respective region of a surface of thepatient body part imaged during a medical examination.

In an embodiment, the reporting circuit 7126 is configured to generateinformational data reporting a surface area of the patient body partcollectively depicted by at least two imaged regions. The informationaldata is at least partially based on the determined correspondence. In anembodiment, the reporting circuit is configured to generateinformational data reporting a surface area of the patient body part notcollectively depicted by any imaged region. The informational data is atleast partially based on the determined correspondence. In anembodiment, the reporting circuit is configured to generateinformational data reporting a determined positive correspondence for atleast one atlas landmark subsurface feature of the at least two atlaslandmark subsurface features. The informational data is at leastpartially based on the determined correspondence. For example, thereporting circuit may generate informational data of a “1”—indicating adetermined positive correspondence for at least one atlas landmarksubsurface feature of the at least two atlas landmark subsurfacefeatures. In an embodiment, the reporting circuit is configured togenerate informational data reporting a determined negative or absenceof a correspondence for at least one atlas landmark subsurface featureof the at least two atlas landmark subsurface features. Theinformational data is at least partially based on the determinedcorrespondence. For example, the reporting circuit may generateinformational data of a “0”—indicating a determined negative or absenceof a correspondence for at least one atlas landmark subsurface featureof the at least two atlas landmark subsurface features.

In an embodiment, the reporting circuit 7126 is configured to generateinformational data reporting a determined positive correspondencebetween (x) a particular atlas landmark subsurface feature of the atleast two atlas landmark subsurface features and (y) an imaged landmarksubsurface feature of the patient body part. The reporting circuit isalso configured to generate informational data reporting a determinednegative correspondence between (x) another atlas landmark subsurfacefeature immediately spatially adjacent to the particular atlas landmarksubsurface feature and (y) each other respective imaged landmarksubsurface feature of the patient body part. An example in use of thisembodiment of the reporting circuit may be illustrated in reference toFIG. 142. If the atlas landmark subsurface feature 7272Y was theparticular atlas landmark subsurface feature, the informational datawould indicate (i) a determined positive correspondence between theatlas landmark subsurface feature 7272Y and the imaged landmarksubsurface feature 7212.2; and (ii) a determined negative correspondencebetween the atlas landmark subsurface 7272X feature immediatelyspatially adjacent to the particular atlas landmark subsurface feature7272Y and each other respective imaged landmark subsurface feature ofthe patient body part. Such informational data when communicated to thehealth care provider may inform them that the imaged the region 7222.2of the surface of the patient body part is spatially adjacent to anun-imaged region or regions of the surface of the patient body part.

In an embodiment, the reporting circuit 7126 is configured to generateinformational data reporting a determined positive correspondencebetween (x) a first atlas landmark subsurface feature of the at leasttwo atlas landmark subsurface features and (y) an imaged landmarksubsurface feature. The reporting circuit is also configured to generateinformational data reporting a first determined negative correspondencebetween (x) a second atlas landmark subsurface feature immediatelyspatially adjacent to the first atlas landmark subsurface feature and(y) each other respective imaged landmark subsurface feature of thepatient body part. The reporting circuit is also configured to generateinformational data reporting a second determined negative correspondencebetween (x) a third atlas landmark subsurface feature also immediatelyspatially adjacent to the first atlas landmark subsurface feature and(y) each other respective imaged landmark subsurface feature of thepatient body part. An example in use of this embodiment the reportcircuit may be illustrated in reference to FIG. 142. If the atlaslandmark subsurface feature 7272B was the particular atlas landmarksubsurface feature, the informational data would indicate (i) adetermined positive correspondence between the atlas landmark subsurfacefeature 7272B and the imaged landmark subsurface feature 7212.1; (ii) adetermined negative correspondence between the atlas landmark subsurface7272A feature immediately spatially adjacent to the particular atlaslandmark subsurface feature 7272B and each other respective imagedlandmark subsurface feature of the patient body part; and (iii) adetermined negative correspondence between the atlas landmark subsurface7272C feature also immediately spatially adjacent to the particularatlas landmark subsurface feature 7272B and each other respective imagedlandmark subsurface feature of the patient body part. Such informationaldata when communicated to the health care provider may inform them thatthe imaged the region 7222.1 of the surface of the patient body part isspatially adjacent on two sides to un-imaged regions of the surface ofthe patient body part.

In an embodiment, the reporting circuit 7126 is configured to generateinformational data reporting at least two spatially adjacent atlaslandmark subsurface features respectively having a determined negativecorrespondence with each imaged landmark subsurface feature of thepatient body part. An example in use of this embodiment of the reportingcircuit may be illustrated in reference to FIG. 142. If the at least twospatially adjacent atlas landmark subsurface features include spatiallyadjacent atlas landmark subsurface features 7272C and 7272D, theinformational data would indicate adjacent atlas landmark subsurfacefeatures 7272C and 7272D respectively have a determined negativecorrespondence with each imaged landmark subsurface feature of thepatient body part. Such informational data when communicated to thehealth care provider may inform them of a zone of adjacent or contiguousun-imaged regions of the surface of the patient body part.

In an embodiment, the reporting circuit 7126 is configured to generateinformational data reporting at least two spatially adjacent atlaslandmark subsurface features respectively having a determined negativecorrespondence with each respective imaged landmark subsurface featureof the patient body part. The reporting circuit is also configured togenerate informational data reporting a first determined positivecorrespondence between (x) a first atlas landmark subsurface feature ofthe at least two atlas landmark subsurface features and (y) an imagedlandmark subsurface feature. The first atlas landmark subsurface featureis spatially adjacent to a terminal atlas landmark subsurface feature ofthe at least two spatially adjacent atlas landmark subsurface featureshaving the determined negative correspondence. The reporting circuit isalso configured to generate informational data reporting a seconddetermined positive correspondence between (x) a second atlas landmarksubsurface feature of the at least two atlas landmark subsurfacefeatures and (y) an imaged landmark subsurface feature. The second atlaslandmark subsurface feature is spatially adjacent to a second terminalatlas landmark subsurface feature of the at least two spatially adjacentatlas landmark subsurface features having the determined negativecorrespondence. An example in use of this embodiment the report circuitmay be illustrated in reference to FIG. 142. If the at least twospatially adjacent atlas landmark subsurface features include spatiallyadjacent atlas landmark subsurface features 7272C and 7272X, the reportcircuit would generate informational data indicating atlas landmarksubsurface features 7272B and 7272Y are at the opposing regions of azone of adjacent or contiguous atlas landmark subsurface features havingdetermined negative correspondences or absence of correspondence. Forexample, the informational data may report [1001].

In an embodiment, the report circuit 7126 is configured to generateinformational data indicative of a determined positive correspondencebetween an imaged landmark subsurface feature of the patient body partand at least one atlas landmark subsurface feature of the at least twoatlas landmark subsurface features. In an embodiment, the report circuitis configured to generate informational data indicative of a determinednegative or absence of a correspondence between an imaged landmarksubsurface feature of the patient body part and each atlas landmarksubsurface feature of the at least two atlas landmark subsurfacefeatures. In an embodiment, the report circuit is configured to outputinformational data indicative of a predicted likelihood that a surfaceregion of the patient body part is substantially absent from therespective imaged regions of the surface of the patient body part of theat least two reference images.

In an embodiment, the subsurface feature atlas includes a subsurfacefeature atlas including a spatial relationship between the at least twoatlas landmark subsurface features of the patient body part. Forexample, FIG. 142 illustrates the subsurface feature atlas 7250indicating a spatial relationship 7254XY between atlas landmarksubsurface feature 7272X and 7272Y. In an embodiment, the subsurfacefeature atlas includes a registration of the at least two atlas landmarksubsurface features of the patient body part. In an embodiment, thesubsurface feature atlas includes at least two atlas landmark subsurfacefeatures of the patient body part. The subsurface feature atlaspreviously prepared in connection with a testing, diagnosis, ortreatment of a possible reference condition of the patient. In anembodiment, the subsurface feature atlas includes a published subsurfacefeature atlas including at least two atlas landmark subsurface featuresof the patient body part. The subsurface feature atlas is arranged in amanner facilitating a testing, diagnosis, or treatment of a possiblemedical condition of patients.

In an embodiment, the system 7120 includes a registration circuit 7128configured to register a spatial relationship of the respective imagedlandmark subsurface feature of each reference image of the at least tworeference images. In an embodiment, the system includes thecomputer-readable media 235 configured to maintain the informationaldata. In an embodiment, the computer-readable media includes acomputer-readable media configured to maintain and to provide electronicaccess to the informational data.

FIG. 143 illustrates an example operational flow 7300. After a startoperation, the operational flow includes a reception operation 7310. Thereception operation includes receiving at least two reference images ofa patient body part. Each reference image of the at least two referenceimages includes a respective landmark subsurface feature of the patientbody part (hereafter “imaged landmark subsurface feature”). Each imagedlandmark subsurface feature has a respective spatial relationship to arespective region of a surface of the patient body part imaged during amedical examination (hereafter “imaged region”). In an embodiment, thereception operation may be implemented using the receiver circuit 7122described in conjunction with FIG. 141. A matching operation 7320includes determining a correspondence between (x) each atlas landmarksubsurface feature of the patient body part of at least two atlaslandmark subsurface features of the patient body part included in alandmark subsurface feature atlas of the patient body part and (y) eachrespective imaged landmark subsurface feature of the patient body partincluded in the at least two reference images. In an embodiment, thematching operation may be implemented using the feature matching circuit7124 described in conjunction with FIG. 141. In an embodiment, thesubsurface atlas may be substantially similar to the subsurface atlas7250 described in conjunction with FIG. 142. In an embodiment, thesubsurface atlas may be substantially similar to the subsurface atlas5250 described in conjunction with FIG. 103. A surface coveragereporting operation 7330 includes generating informational datareporting a depiction of an area of the surface of the patient body partby at least two adjacent imaged regions. The informational data is atleast partially based on the determined correspondence. In anembodiment, the reporting operation may be implemented using thereporting circuit 7126 described in conjunction with FIG. 141. Acommunication operation 7350 includes outputting the informational data.In an embodiment, the communication operation may be implemented usingthe communications circuit 7142 described in conjunction with FIG. 141.The operational flow includes an end operation.

In an alternative embodiment, the operational flow may include aninformation storage operation 7360. The information storage operationincludes saving the informational data in a computer-readable medium.

FIG. 144 illustrates an alternative embodiment of the operational flow7300 of FIG. 143. In an embodiment, the reception operation 7310 mayinclude at least one additional embodiment. The at least one additionalembodiment may include an operation 7311, an operation 7312, or anoperation 7313. The operation 7311 includes receiving at least tworeference images of a patient body part having a cavity or lumen. Eachreference image of the at least two reference images includes arespective landmark subsurface feature of the patient body part has arespective spatial relationship to a respective imaged region of asurface of the cavity or lumen of the patient body part. The operation7312 includes receiving at least two reference images of a patient bodypart, each reference image of the at least two reference images acquiredby a body-insertable device and including a respective landmarksubsurface feature of the patient body part. Each imaged landmarksubsurface feature has a respective spatial relationship to a respectiveregion of a surface of the patient body part imaged during a medicalexamination. The operation 7313 includes receiving at least tworeference images of a patient body part, each reference image of the atleast two reference images acquired by an ex vivo device and including arespective landmark subsurface feature of the patient body part. Eachimaged landmark subsurface feature has a respective spatial relationshipto a respective region of a surface of the patient body part imagedduring a medical examination.

FIG. 145 illustrates an alternative embodiment of the operational flow7300 of FIG. 143. In an embodiment, the surface coverage operation 7330may include at least one additional embodiment. The at least oneadditional embodiment may include an operation 7331, an operation 7332,an operation 7333, or an operation 7334. The operation 7331 includesgenerating informational data reporting a surface area of the patientbody part collectively depicted by at least two adjacent imaged regions.The informational data is at least partially based on the determinedcorrespondence. The operation 7332 includes generating informationaldata reporting a surface area of the patient body part not collectivelydepicted by any imaged region. The informational data is at leastpartially based on the determined correspondence. The operation 7333includes generating informational data reporting a determined positivecorrespondence for at least one atlas landmark subsurface feature of theat least two atlas landmark subsurface features. The informational datais at least partially based on the determined correspondence. Theoperation 7334 includes generating informational data reporting adetermined negative or absence of a correspondence for at least oneatlas landmark subsurface feature of the at least two atlas landmarksubsurface features. The informational data is at least partially basedon the determined correspondence.

FIG. 146 illustrates an alternative embodiment of the operational flow7300 of FIG. 143. In an embodiment, the surface coverage operation 7330may include at least one additional embodiment. The at least oneadditional embodiment may include an operation 7335, an operation 7336,or an operation 7337. The operation 7335 includes generatinginformational data reporting (i) a determined positive correspondencebetween (x) a particular atlas landmark subsurface feature of the atleast two atlas landmark subsurface features and (y) an imaged landmarksubsurface feature of the patient body part. The operation 7335 alsoincludes generating informational data reporting (ii) a determinednegative correspondence between (x) another atlas landmark subsurfacefeature immediately spatially adjacent to the particular atlas landmarksubsurface feature and (y) each other respective imaged landmarksubsurface feature of the patient body part. The operation 7336 alsoincludes generating informational data reporting (i) a determinedpositive correspondence between (x) a first atlas landmark subsurfacefeature of the at least two atlas landmark subsurface features and (y)an imaged landmark subsurface feature. The operation 7336 also includesgenerating informational data reporting (ii) a first determined negativecorrespondence between (x) a second atlas landmark subsurface featureimmediately spatially adjacent to the first atlas landmark subsurfacefeature and (y) each other respective imaged landmark subsurface featureof the patient body part. The operation 7336 also includes generatinginformational data reporting (iii) a second determined negativecorrespondence between (x) a third atlas landmark subsurface featurealso immediately spatially adjacent to the first atlas landmarksubsurface feature and (y) each other respective imaged landmarksubsurface feature of the patient body part. The operation 7337 includesgenerating informational data reporting at least two spatially adjacentatlas landmark subsurface features respectively having a determinednegative correspondence with each imaged landmark subsurface feature ofthe patient body part.

FIG. 147 illustrates an alternative embodiment of the operational flow7300 of FIG. 143. In an embodiment, the surface coverage operation 7330may include at least one additional embodiment. The at least oneadditional embodiment may include an operation 7338, an operation 7339,an operation 7341, or an operation 7342. The operation 7338 includesgenerating informational data reporting (i) at least two spatiallyadjacent atlas landmark subsurface features respectively having adetermined negative correspondence with each respective imaged landmarksubsurface feature of the patient body part. The operation 7338 alsoincludes generating informational data reporting (ii) a first determinedpositive correspondence between (x) a first atlas landmark subsurfacefeature of the at least two atlas landmark subsurface features and (y)an imaged landmark subsurface feature. The first atlas landmarksubsurface feature is spatially adjacent to a terminal atlas landmarksubsurface feature of the at least two spatially adjacent atlas landmarksubsurface features having the determined negative correspondence. Theoperation 7338 also includes generating informational data reporting(iii) a second determined positive correspondence between (x) a secondatlas landmark subsurface feature of the at least two atlas landmarksubsurface features and (y) an imaged landmark subsurface feature, thesecond atlas landmark subsurface feature spatially adjacent to a secondterminal atlas landmark subsurface feature of the at least two spatiallyadjacent atlas landmark subsurface features having the determinednegative correspondence. The operation 7339 includes generatinginformational data reporting a determined positive correspondencebetween an imaged landmark subsurface feature of the patient body partand at least one atlas landmark subsurface feature of the at least twoatlas landmark subsurface features. The operation 7341 includesgenerating informational data reporting a determined negative or absenceof a correspondence between an imaged landmark subsurface feature of thepatient body part and each atlas landmark subsurface feature of the atleast two atlas landmark subsurface features. The operation 7342includes generating informational reporting a predicted likelihood thatan area of surface of the patient body part is at least substantiallyabsent from the imaged regions of the surface of the patient body part.

FIG. 148 illustrates an alternative embodiment of the operational flow7300 of FIG. 143. In an embodiment, the communication operation 7350 mayinclude at least one additional embodiment. The at least one additionalembodiment may include an operation 7351, an operation 7352, anoperation 7353, or an operation 7354. The operation 7351 includesoutputting informational data usable in displaying a human-perceivableindication of the determined correspondence for at least one atlaslandmark subsurface feature of the at least two atlas landmarksubsurface features included in the subsurface feature atlas. Theoperation 7352 includes transforming the informational data into aparticular visual depiction of a location of an un-imaged region of thesurface of the patient body part relative to a larger portion of thesurface of the patient body part, and outputting the transformedinformational data. The operation 7353 includes transforming theinformational data into a particular visual depiction of a location ofat least two un-imaged regions of the surface of the patient body partrelative to a larger portion of the surface of the patient body part,and outputting the transformed informational data. The operation 7354includes transforming the informational data into a particular visualdepiction of relative spatial positions of the respective image regionsof the surface of the patient body part and outputting the transformedinformational data.

FIG. 149 illustrates an example computer program product 7400. Thecomputer program product includes a computer-readable media 7410 bearingprogram instructions 7420. The program instructions, when executed by aprocessor of a computing device, cause the computing device to perform aprocess. The process includes receiving at least two reference images ofa patient body part. Each reference image of the at least two referenceimages includes a respective landmark subsurface feature of the patientbody part (hereafter “imaged landmark subsurface feature”). Each imagedlandmark subsurface feature has a respective spatial relationship to arespective region of a surface of the patient body part imaged during amedical examination (hereafter “imaged region”). The process includesdetermining a correspondence between (x) each atlas landmark subsurfacefeature of the patient body part of at least two atlas landmarksubsurface features of the patient body part included in a landmarksubsurface feature atlas of the patient body part and (y) eachrespective imaged landmark subsurface feature of the patient body partincluded in the at least two reference images. The process includesgenerating informational data reporting a depiction of an area of thesurface of the patient body part by at least two adjacent imagedregions, the informational data is at least partially based on thedetermined correspondence. The process includes outputting theinformational data. In an embodiment, the process further includes 7422storing the informational data in another computer-readable mediaoperably coupled with the processor.

In an embodiment, the computer-readable media 7410 includes a tangiblecomputer-readable media 7412. In an embodiment, the computer-readablemedia includes a communications media 7414.

FIG. 150 illustrates an example system 7500. The system includes means7510 for receiving at least two reference images of a patient body part.Each reference image of the at least two reference images includes arespective landmark subsurface feature of the patient body part(hereafter “imaged landmark subsurface feature”). Each imaged landmarksubsurface feature has a respective spatial relationship to a respectiveregion of a surface of the patient body part imaged during a medicalexamination (hereafter “imaged region”). The system includes means 7520for determining a correspondence between (x) each atlas landmarksubsurface feature of the patient body part of at least two atlaslandmark subsurface features of the patient body part included in alandmark subsurface feature atlas of the patient body part and (y) eachrespective imaged landmark subsurface feature of the patient body partincluded in the at least two reference images. The system includes means7530 for generating informational data reporting a depiction of an areaof the surface of the patient body part by at least two adjacent imagedregions, the informational data is at least partially based on thedetermined correspondence. The system includes means 7540 for outputtingthe informational data.

An embodiment includes a system (not shown) that indicates a possible ora determined unimaged region of a surface of a mammalian body. In anembodiment, a system includes an image receiver circuit configured toreceive a plurality of medical images. Each medical image of theplurality of medical images has at least one peripheral edge portion,and each medical image of the plurality of medical images including arespective imaged region of a mammalian body part. For example, theimaged region may include an imaged region of a surface of a mammalianbody part. For example, the imaged region may include an imaged regionof a surface of a cavity or lumen of a mammalian body part. For example,a medical image may have been acquired by a body-insertable device whilepresent within the mammalian body. The system also includes an analysiscircuit configured to determine an edge overlap status of a peripheraledge of the at least one peripheral edge of a selected medical image ofthe plurality of medical images. The peripheral edge overlap status isresponsive to or at least partially based on a correspondence between(x) a content of the peripheral edge of the at least one peripheral edgeof a selected medical image and (y) a content of each medical image ofthe plurality of medical images other than the selected medical image.In other words, the content of the peripheral edge of a selected medicalimage is attempted to be matched to the content of all the peripheraledges of another medical image. In an embodiment, (y) may include acontent of each peripheral edge of each medical image of the pluralityof medical images other than the selected medical image. The systemfurther includes list management circuit configured to add thedetermined peripheral edge overlap status to an edge overlap list forthe mammalian body part. For example, a determination of an edge overlapmay be indicated by a “1” on the edge overlap list for the peripheraledge of the at least one peripheral edge of the selected medical image,and a determination of no edge overlap may be indicated by a “0” on theedge overlap list for the peripheral edge of the at least one peripheraledge of a selected medical image. The system also includes a dataanalysis circuit configured to determine that a particular region of themammalian body part is not included in the plurality of medical images(hereafter “non-imaged region”). The determination is at least partiallybased on at least one instance of a non-overlapped edge status for aperipheral edge of a medical image of the plurality of medical imagesindicated on the edge overlap list. The system includes a communicationscircuit configured to output the informational data. In an embodiment,the system may include an edge overlap analysis circuit configured topredict a likelihood that a surface region of the patient body part issubstantially absent from the respective imaged regions of the surfaceof the patient body part included in the at least two medical images.The predicting is at least partially based on the edge overlap list. Anexample of imagery coverage estimates and analyses is provided by C.Gebhardt, RCC Imagery Analysis Procedures Explored in STS-127 TPSDocumentation,http://www.nasaspaceflight.com/2009/07/rcc-procedures-explored-sts-127-tps/(accessed Aug. 18, 2011).

An embodiment includes a system that indicates a possible or adetermined unimaged surface of an mammalian body part (not illustrated).In an embodiment, a system includes an image receiver circuit configuredto receive a plurality of medical images. Each medical image of theplurality of medical images has at least one peripheral edge portion,and each medical image of the plurality of medical images including arespective imaged region of a mammalian body part. For example, theimaged region may include an imaged region of a surface of a mammalianbody part. For example, the imaged region may include an imaged regionof a surface of a cavity or lumen of a mammalian body part. For example,a medical image may have been acquired by a body-insertable device whilepresent within the mammalian body. The system also includes a detectioncircuit configured to detect a feature of a peripheral edge of the atleast one peripheral edge of a medical image of the plurality of medicalimages (hereafter “detected peripheral edge feature”). The systemincludes an edge-overlap analysis circuit configured to determine anedge overlap status of a peripheral edge of the at least one peripheraledge of a selected medical image of the plurality of medical images. Theperipheral edge overlap status is responsive to or at least partiallybased on a correspondence between (x) a detected peripheral edge featureof a peripheral edge of the at least one peripheral edge of a selectedmedical image and (y) each detected peripheral edge feature of eachperipheral edge of each medical image of the plurality of medical imagesother than the selected medical image. In other words, the detectedperipheral edge feature of the peripheral edge of a selected medicalimage is attempted to be matched to the detected peripheral edgefeatures of all of the medical images. For example, if a negative or nocorrespondence is found, i.e., there is no common detected peripheraledge feature with at least one of the remaining medical images, thesystem presumes or interprets the negative correspondence as anindication that there is an unimaged adjacent region adjacent to theselected medical image. For example, if a positive correspondence isfound, i.e., there is a common detected peripheral edge feature with atleast one of the remaining medical images, the system presumes orinterprets the positive correspondence as an indication that the regionadjacent to the selected medical image is likely imaged. The systemfurther includes list management circuit configured to add thedetermined peripheral edge overlap status to an edge overlap list forthe mammalian body part. For example, a determination of an edge overlapmay be indicated by a “1” on the edge overlap list for the peripheraledge of the at least one peripheral edge of the selected medical image,and a determination of no edge overlap may be indicated by a “0” on theedge overlap list for the peripheral edge of the at least one peripheraledge of a selected medical image. The system also includes a first dataanalysis circuit configured to determine that a particular region of themammalian body part is not included in the plurality of medical images(hereafter “non-imaged region”). The indication of a non-imaged regionis at least partially based on at least one instance of a non-overlappededge status for a peripheral edge of a medical image of the plurality ofmedical images indicated on the edge overlap list. The system includes adata analysis circuit configured to determine that a particular regionof the mammalian body part is not included in the respective imagedregions of the mammalian body part of the plurality of medical images(hereafter “particular non-imaged region”). The data analysis circuit isalso configured to determine a spatial relationship between theparticular non-imaged region and a detected peripheral edge feature ofthe selected medical image of the plurality of medical images. Thedeterminations are at least partially based on the indication of anon-imaged region and the edge overlap list. The system includes acomputer-readable media configured to maintain informational datacorresponding to the particular non-imaged region. The system includes acommunications device configured to output informational data.

In an embodiment, the system may include an edge overlap analysiscircuit configured to predict a likelihood that a surface region of thepatient body part is substantially absent from the respective imagedregions of the surface of the patient body part included in the at leasttwo medical images.

In an embodiment, the detection circuit includes a feature detectioncircuit configured to detect a surface feature proximate to at least oneperipheral edge of a respective imaged region of the surface of thecavity or lumen of the body part included in each medical image of theplurality of medical images. In an embodiment, the detection circuitincludes a feature detection circuit configured to detect a subsurfacefeature proximate to at least one peripheral edge of a respective imagedregion of the surface of the cavity or lumen of the patient body partincluded in each medical image of the plurality of medical images. In anembodiment, the detection circuit includes a feature detection circuitconfigured to detect and extract a feature proximate to at least oneperipheral edge of a respective imaged region of the surface of thecavity or lumen of the patient body part included in each medical imageof the plurality of medical images. In an embodiment, the detectioncircuit includes a feature detection circuit configured to detect atleast one of an anatomical feature of the cavity or lumen, a pattern, ora feature of the image proximate to at least one peripheral edge of arespective imaged region of the surface of the cavity or lumen of thepatient body part included in each medical image of the plurality ofmedical images. In an embodiment, the detection circuit includes afeature detection circuit configured to detect a feature proximate toeach peripheral edge of a respective imaged region of the surface of thecavity or lumen of the patient body part included in each medical imageof the plurality of medical images.

In an embodiment, the edge overlap analysis circuit includes an edgeoverlap analysis circuit configured to determine an absence of aperipheral edge overlap in response to a negative correspondence between(x) a detected peripheral edge feature of an imaged region of thesurface of the cavity or lumen of the patient body part included in afirst medical image of the plurality of medical images and (y) eachdetected peripheral edge feature of each imaged region of the surface ofthe cavity or lumen of the patient body part included the remainingmedical images of the plurality of medical images. In an embodiment, theedge overlap analysis circuit includes an edge overlap analysis circuitconfigured to determine a correspondence between (x) a detectedperipheral edge feature of an imaged region of the surface of the cavityor lumen of the patient body part included in a first medical image ofthe plurality of medical images and (y) each detected peripheral edgefeature of each imaged region of the surface of the cavity or lumen ofthe patient body part included the remaining medical images of theplurality of medical images, and to iteratively determine acorrespondence between each detected peripheral edge feature of eachimaged region included in each medical image of the plurality of medicalimages and each detected peripheral edge feature of each imaged regionof each other medical image of the plurality of medical images. In anembodiment, the edge overlap analysis circuit includes an edge overlapanalysis circuit configured to determine an absence of a peripheral edgeoverlap by mapping (x) each detected peripheral edge feature of animaged region of the surface of the cavity or lumen of the patient bodypart included in each medical image of the plurality of medical imagesto (y) each detected peripheral edge feature of each imaged region ofeach other medical image of the plurality of medical images.

In an embodiment, the data analysis circuit includes a data analysiscircuit configured to gather data indicative of a determined absence ofa detected peripheral edge feature overlap for at least one peripheraledge feature of an imaged region of the surface of the cavity or lumenof the patient body part included in a medical image of the plurality ofmedical images. In an embodiment, the data analysis circuit includes adata analysis circuit configured to gather data indicative of adetermined presence of a detected peripheral edge feature overlap for atleast one peripheral edge feature of an imaged region of the surface ofthe cavity or lumen of the patient body part included in a medical imageof the plurality of medical images.

In an embodiment, the communication device includes a communicationdevice configured to display the informational data, including ahuman-perceivable indication of a possible non-imaged region, theindication of the possible non-imaged region at least partially based ona determined negative correspondence by the edge overlap analysiscircuit. In an embodiment, the communication device includes acommunication device configured to display the informational data,including a human-perceivable indication of a non-imaged region, theindication of the non-imaged region at least partially based on adetermined absence of a detected peripheral edge feature overlap for thefirst medical image by the edge overlap analysis circuit. In anembodiment, the communication device includes a communication deviceconfigured to display the informational data, including displaying ahuman-perceivable indication of a non-imaged region, and a location[with reference to subsurface feature] of the non-imaged region, theindication and the location of the non-imaged region at least partiallybased on a determination by the edge overlap analysis circuit of anabsence of an edge overlap.

In an embodiment, the system includes an edge detection circuitconfigured to detect a peripheral edge of a selected medical image. Inan embodiment, the system includes a location analysis circuitconfigured to indicate a location of the non-imaged region. The locationindication is at least partially based on the portion of the edgeoverlap list indicative of a determined negative correspondence. In anembodiment, the location analysis circuit includes a location analysiscircuit configured to indicate a location of the possible non-imagedregion, the location indication is at least partially based on the edgeoverlap list indicative of a determined negative correspondence by theedge overlap analysis circuit. In an embodiment, the location analysiscircuit includes a location analysis circuit configured to indicate alocation of the non-imaged region. The location is indicated relative tothe imaged region of the surface of the cavity or lumen of the patientbody part included in the first medical image of the plurality ofmedical images, and the location indication at least partially based onthe gathered data indicative of the determined correspondence by theedge overlap analysis circuit. In an embodiment, the location analysiscircuit includes a location analysis circuit configured to indicate alocation of the non-imaged region. The location is indicated relative toa site within the imaged region of the surface of the cavity or lumen ofthe patient body part included in the first medical image of theplurality of medical images, and the location indication at leastpartially based on the gathered data indicative of a determined negativecorrespondence by the edge overlap analysis circuit. In an embodiment,the location analysis circuit includes a location analysis circuitconfigured to indicate a location of the non-imaged region. The locationis indicated (i) relative to a site within the imaged region and (ii)relative to the determined non-overlapped detected peripheral edgefeature of the surface of the cavity or lumen of the patient body partincluded in the first medical image of the plurality of medical images,and the location indication at least partially based on the gathereddata indicative of the determined correspondence by the edge overlapanalysis circuit. In an embodiment, the location analysis circuitincludes a location analysis circuit configured to indicate a locationof a non-imaged region. The location is indicated by a linesubstantially perpendicular to the peripheral edge of the first medicalimage having a detected peripheral edge feature with a determinednegative correspondence (i.e. non-overlapped), and the locationindication at least partially based on the gathered data indicative ofthe determined correspondence by the edge overlap analysis circuit. Inan embodiment, the location analysis circuit includes a locationanalysis circuit configured to indicate a location of a non-imagedregion. The location indication is at least partially based on a closedcurve substantially formed by linking (i) the peripheral edge having adetected peripheral edge feature with a determined negativecorrespondence (non-overlapped, all “0” correspondences) of the firstmedical image and (ii) a respective peripheral edge having a detectedperipheral edge feature with a determined negative correspondence of atleast one other proximate medical image of the plurality of medicalimages. In an embodiment, the location analysis circuit includes alocation analysis circuit configured to indicate a location of anon-imaged site of the surface of the cavity or lumen of the patientbody part. The indication of the site is at least partially based on aclosed curve substantially formed by linking (i) the peripheral edgehaving a detected peripheral edge feature with a determined negativecorrespondence (i.e. non-overlapped, all “0” correspondences) of thefirst medical image and (ii) a respective peripheral edge having adetected peripheral edge feature with a determined negativecorrespondence of at least one other proximate medical image of theplurality of medical images. In an embodiment, the location analysiscircuit includes a location analysis circuit configured to indicate apossible non-imaged region of the surface of the cavity or lumen of thepatient body part. The indication of a non-imaged region is at leastpartially based on a negative determined correspondence for at least twoproximate detected peripheral edge features of one peripheral edge of arespective imaged region of the surface of the cavity or lumen of thepatient body part included in the first medical image. For example, if anegative correspondence {all=“0”} for two proximate detected peripheraledge features is found with any other detected peripheral edge featureof the remaining medical images there is no edge overlap and a possiblenon-imaged region exists.

In an embodiment, the system includes a filter circuit configured toreceive a medical image determined by the edge overlap analysis circuitto have a negative correspondence (an absence of an edge overlap). Thefilter circuit is also configured to determine that the imaged region ofthe surface of the cavity or lumen of the patient body part included inthe received medical image includes an end-region of the cavity or lumenproximate to a terminus of the surface of the cavity or lumen of thepatient body part. The filter circuit is also configured to remove themedical image from the at least two medical images (hereafter “filteredat least two medical images”).

All references cited herein are hereby incorporated by reference intheir entirety or to the extent their subject matter is not otherwiseinconsistent herewith.

In some embodiments, “configured” includes at least one of designed, setup, shaped, implemented, constructed, or adapted for at least one of aparticular purpose, application, or function.

It will be understood that, in general, terms used herein, andespecially in the appended claims, are generally intended as “open”terms. For example, the term “including” should be interpreted as“including but not limited to.” For example, the term “having” should beinterpreted as “having at least.” For example, the term “has” should beinterpreted as “having at least.” For example, the term “includes”should be interpreted as “includes but is not limited to,” etc. It willbe further understood that if a specific number of an introduced claimrecitation is intended, such an intent will be explicitly recited in theclaim, and in the absence of such recitation no such intent is present.For example, as an aid to understanding, the following appended claimsmay contain usage of introductory phrases such as “at least one” or “oneor more” to introduce claim recitations. However, the use of suchphrases should not be construed to imply that the introduction of aclaim recitation by the indefinite articles “a” or “an” limits anyparticular claim containing such introduced claim recitation toinventions containing only one such recitation, even when the same claimincludes the introductory phrases “one or more” or “at least one” andindefinite articles such as “a” or “an” (e.g., “a receiver” shouldtypically be interpreted to mean “at least one receiver”); the sameholds true for the use of definite articles used to introduce claimrecitations. In addition, even if a specific number of an introducedclaim recitation is explicitly recited, it will be recognized that suchrecitation should typically be interpreted to mean at least the recitednumber (e.g., the bare recitation of “at least two chambers,” or “aplurality of chambers,” without other modifiers, typically means atleast two chambers).

In those instances where a phrase such as “at least one of A, B, and C,”“at least one of A, B, or C,” or “an [item] selected from the groupconsisting of A, B, and C,” is used, in general such a construction isintended to be disjunctive (e.g., any of these phrases would include butnot be limited to systems that have A alone, B alone, C alone, A and Btogether, A and C together, B and C together, or A, B, and C together,and may further include more than one of A, B, or C, such as A₁, A₂, andC together, A, B₁, B₂, C₁, and C₂ together, or B₁ and B₂ together). Itwill be further understood that virtually any disjunctive word or phrasepresenting two or more alternative terms, whether in the description,claims, or drawings, should be understood to contemplate thepossibilities of including one of the terms, either of the terms, orboth terms. For example, the phrase “A or B” will be understood toinclude the possibilities of “A” or “B” or “A and B.”

The herein described aspects depict different components containedwithin, or connected with, different other components. It is to beunderstood that such depicted architectures are merely examples, andthat in fact many other architectures can be implemented which achievethe same functionality. In a conceptual sense, any arrangement ofcomponents to achieve the same functionality is effectively “associated”such that the desired functionality is achieved. Hence, any twocomponents herein combined to achieve a particular functionality can beseen as “associated with” each other such that the desired functionalityis achieved, irrespective of architectures or intermedial components.Likewise, any two components so associated can also be viewed as being“operably connected,” or “operably coupled,” to each other to achievethe desired functionality. Any two components capable of being soassociated can also be viewed as being “operably couplable” to eachother to achieve the desired functionality. Specific examples ofoperably couplable include but are not limited to physically mateable orphysically interacting components or wirelessly interactable orwirelessly interacting components.

With respect to the appended claims the recited operations therein maygenerally be performed in any order. Also, although various operationalflows are presented in a sequence(s), it should be understood that thevarious operations may be performed in other orders than those which areillustrated, or may be performed concurrently. Examples of suchalternate orderings may include overlapping, interleaved, interrupted,reordered, incremental, preparatory, supplemental, simultaneous,reverse, or other variant orderings, unless context dictates otherwise.Use of “Start,” “End,” “Stop,” or the like blocks in the block diagramsis not intended to indicate a limitation on the beginning or end of anyoperations or functions in the diagram. Such flowcharts or diagrams maybe incorporated into other flowcharts or diagrams where additionalfunctions are performed before or after the functions shown in thediagrams of this application. Furthermore, terms like “responsive to,”“related to,” or other past-tense adjectives are generally not intendedto exclude such variants, unless context dictates otherwise.

While various aspects and embodiments have been disclosed herein, otheraspects and embodiments will be apparent to those skilled in the art.The various aspects and embodiments disclosed herein are for purposes ofillustration and are not intended to be limiting, with the true scopeand spirit being indicated by the following claims.

1.-22. (canceled)
 23. A system comprising: (a) a coordinate analysiscircuit configured to determine a common frame of reference at leastpartially based on a landmark subsurface feature of a mammalian bodypart, the mammalian body part having at least two landmark subsurfacefeatures and at least two regions of interest, each landmark subsurfacefeature of the at least two landmark subsurface features having arespective spatial relationship to a respective region of interest ofthe at least two regions of interest; (b) a registration circuitconfigured to register the respective regions of interest of themammalian body part, the registration at least partially based on thedetermined common frame of reference; and (c) a computer-readable mediaconfigured to maintain informational data corresponding to therespective registered regions of interest.
 24. The system of claim 23,wherein the coordinate analysis circuit includes: a coordinate analysiscircuit configured to determine a common frame of reference at leastpartially based on a landmark subsurface feature of a cavity or lumen ofa mammalian body part, the cavity or lumen of the mammalian body parthaving at least two landmark subsurface features and at least tworegions of interest, each landmark subsurface feature of the at leasttwo landmark subsurface features having a respective spatialrelationship to a respective region of interest of the at least tworegions of interest.
 25. The system of claim 23, wherein the coordinateanalysis circuit includes: a coordinate analysis circuit configured todetermine a common frame of reference at least partially based on alandmark subsurface feature of a cavity or lumen of a mammalian bodypart, the cavity or lumen of the mammalian body part having at least twolandmark subsurface features and at least two regions of interest of asurface of the cavity or lumen, each landmark subsurface feature of theat least two landmark subsurface features having a respective spatialrelationship to a respective region of interest of the at least tworegions of interest.
 26. The system of claim 23, wherein the coordinateanalysis circuit includes: a coordinate analysis circuit configured todetermine a common frame of reference and a coordinate system at leastpartially based on a landmark subsurface feature of a mammalian bodypart having at least two landmark subsurface features and at least tworegions of interest, each landmark subsurface feature of the at leasttwo landmark subsurface features having a respective spatialrelationship to a respective region of interest of the at least tworegions of interest.
 27. The system of claim 23, wherein the coordinateanalysis circuit includes: a coordinate analysis circuit configured todetermine a common frame of reference anchored in a landmark subsurfacefeature of a mammalian body part having at least two landmark subsurfacefeatures and at least two regions of interest, each landmark subsurfacefeature of the at least two landmark subsurface features having arespective spatial relationship to a respective region of interest ofthe at least two regions of interest.
 28. The system of claim 23,wherein the registration circuit includes: a registration circuitconfigured to register the respective regions of interest of themammalian body part, the registration at least partially based on thedetermined common frame of reference and on a spatial relationship amongeach landmark subsurface feature of the at least two landmark subsurfacefeatures.
 29. The system of claim 23, wherein the registration circuitincludes: a registration circuit configured to register a spatialrelationship of the respective regions of interest of a mammalian bodypart with respect to each other region of interest of the at least tworegions of interest, the registration at least partially based on thecommon frame of reference.
 30. The system of claim 23, wherein theregistration circuit includes: a registration circuit configured toregister the respective regions of interest of a mammalian body part,the registration including an orientation of the respective regions ofinterest, and the registration at least partially based on the commonframe of reference.
 31. The system of claim 23, wherein thecomputer-readable media includes: a computer-readable media configuredto maintain informational data corresponding to the respectiveregistered regions of interest, and corresponding to the determinedcommon frame of reference.
 32. The system of claim 23, furthercomprising: a communication circuit configured to output theinformational data.
 33. The system of claim 23, further comprising: acommunication circuit configured to provide a notification at leastpartially based on the informational data to at least one of a human,computer, or system.
 34. The system of claim 23, further comprising: areceiver circuit configured to receive at least two medical images, eachmedical image of the at least two medical images includes a respectiveregion of interest of the mammalian body part.
 35. The system of claim23, further comprising: a receiver circuit configured to receive atleast two reference images, each reference image of the at least tworeference images includes a respective landmark subsurface feature ofthe mammalian body part, each landmark subsurface feature having arespective spatial relationship to a respective region of interestincluded in a medical image of the at least two medical images.
 36. Amethod implemented in a computing device, the method comprising: (a)receiving at least two medical images, each medical image of the atleast two medical images includes a respective region of interest of amammalian body part; (b) receiving at least two reference images, eachreference image of the at least two reference images includes arespective landmark subsurface feature of the mammalian body part, eachlandmark subsurface feature having a respective spatial relationship toa respective region of interest included in a medical image of the atleast two medical images; (c) determining a common frame of reference atleast partially based on a landmark subsurface feature included in areference image of the at least two reference images; (d) registeringthe respective regions of interest included in the at least two medicalimages, the registration at least partially based on the common frame ofreference; and (e) maintaining in a computer-readable mediainformational data corresponding to the registration of the respectiveregions of interest included in the at least two medical images.
 37. Themethod of claim 36, wherein the determining includes: determining acommon frame of reference and determining a spatial relationship amongeach respective landmark subsurface feature of the at least tworeference images, the determining at least partially based on a landmarksubsurface feature included in a reference image of the at least tworeference images.
 38. The method of claim 37, wherein the registeringincludes: registering the respective regions of interest included in theat least two medical images, the registration at least partially basedon the common frame of reference and on the spatial relationship amongeach respective landmark subsurface feature of the at least tworeference images.
 39. The method of claim 36, wherein the maintainingincludes: maintaining in a computer-readable media informational datacorresponding to the registration of the respective regions of interest,and providing electronic access to the informational data.
 40. Themethod of claim 36, further comprising: extracting the respectivelandmark subsurface features of the mammalian body part from the atleast two reference images.
 41. The method of claim 36, furthercomprising: outputting data usable in displaying a human-perceivableindication of the informational data.
 42. The method of claim 36,further comprising: transforming the informational data into aparticular visual depiction of the registration of the respectiveregions of interest included in the at least two medical images.
 43. Themethod of claim 36, further comprising: transforming the informationaldata into a particular visual depiction of the relative spatialrelationships of the respective regions of interest included in the atleast two medical images.
 44. The method of claim 36, furthercomprising: outputting the informational data.
 45. The method of claim36, further comprising: providing a notification at least partiallybased on the informational data to at least one of a human, computer, orsystem.
 46. A method comprising: determining a common frame of referenceat least partially based on a landmark subsurface feature of a mammalianbody part having at least two landmark subsurface features and at leasttwo regions of interest, each landmark subsurface feature of the atleast two landmark subsurface features having a respective spatialrelationship to a respective region of interest of the at least tworegions of interest; registering the respective regions of interest ofthe mammalian body part, the registration at least partially based onthe common frame of reference; and maintaining in a computer-readablemedia informational data corresponding to the respective registeredregions of interest.
 47. The method of claim 46, wherein the determiningincludes: determining a common frame of reference at least partiallybased on a landmark subsurface feature of a cavity or lumen of amammalian body part, the cavity or lumen of the mammalian body parthaving at least two landmark subsurface features and at least tworegions of interest, each landmark subsurface feature of the at leasttwo landmark subsurface features having a respective spatialrelationship to a respective region of interest of the at least tworegions of interest.
 48. The method of claim 46, wherein the determiningincludes: determining a common frame of reference at least partiallybased on a landmark subsurface feature of a cavity or lumen of amammalian body part, the cavity or lumen of the mammalian body parthaving at least two landmark subsurface features and at least tworegions of interest of a surface of the cavity or lumen, each landmarksubsurface feature of the at least two landmark subsurface featureshaving a respective spatial relationship to a respective region ofinterest of the at least two regions of interest.
 49. The method ofclaim 46, wherein the registering includes: registering the respectiveregions of interest of the mammalian body part, the registration atleast partially based on the determined common frame of reference and ona spatial relationship among each landmark subsurface feature of the atleast two landmark subsurface features.
 50. The method of claim 46,wherein the maintaining includes: maintaining in a computer-readablemedia informational data corresponding to the respective registeredregions of interest, and providing electronic access to theinformational data.
 51. The method of claim 46, further comprising:transforming the informational data into a particular visual depictionof the respective registered regions of interest.
 52. The method ofclaim 46, further including: transforming the informational data into aparticular visual depiction of a spatial relationship among therespective registered regions of interest.
 53. The method of claim 46,further comprising: outputting the informational data.
 54. The method ofclaim 46, further comprising: providing a notification at leastpartially based on the informational data to at least one of a human,computer, or system.
 55. The method of claim 46, further comprising:receiving at least two medical images, each medical image of the atleast two medical images includes a respective region of interest of themammalian body part.
 56. The method of claim 46, further comprising:receiving at least two reference images, each reference image of the atleast two reference images includes a respective landmark subsurfacefeature of the mammalian body part, each landmark subsurface featurehaving a respective spatial relationship to a respective region ofinterest included in a medical image of at least two medical images.57.-68. (canceled)
 69. A computer program product comprising: (a)program instructions which, when executed by a processor of a computingdevice, cause the computing device to perform a process including: (i)determining a common frame of reference at least partially based on alandmark subsurface feature of a mammalian body part having at least twolandmark subsurface features and at least two regions of interest, eachlandmark subsurface feature of the at least two landmark subsurfacefeatures having a respective spatial relationship to a respective regionof interest of the at least two regions of interest; (ii) registeringthe respective regions of interest of the mammalian body part, theregistration at least partially based on the determined common frame ofreference; and (iii) storing in another computer-readable media operablycoupled with processor informational data corresponding to therespective registered regions of interest; and (b) a computer-readablemedia bearing the program instructions.
 70. The computer program productof claim 69, wherein the process further includes: transforming theinformational data into a signal useable in providing a particularvisual depiction of the respective registered regions of interest. 71.The computer program product of claim 69, wherein the process furtherincludes: providing a notification at least partially based on theinformational data to at least one of a human, computer, or system. 72.The computer program product of claim 69, wherein the computer-readablemedia includes a tangible computer-readable media.
 73. The computerprogram product of claim 69, wherein the computer-readable mediaincludes a communications media.
 74. (canceled)
 75. A system comprising;means for determining a common frame of reference at least partiallybased on a landmark subsurface feature of a mammalian body part, themammalian body part having at least two landmark subsurface features andat least two regions of interest, each landmark subsurface feature of atleast two landmark subsurface features having a respective spatialrelationship to a respective region of interest of the at least tworegions of interest; means for registering the respective regions ofinterest of the mammalian body part, the registration at least partiallybased on the common frame of reference; and means for persistentlymaintaining computer-readable informational data corresponding to therespective registered regions of interest.
 76. The system of claim 75,further comprising: means for transforming the informational data into aparticular visual depiction of the respective registered regions ofinterest.
 77. The system of claim 75, further comprising: means foroutputting the informational data.
 78. The system of claim 75, furthercomprising: means for providing a notification at least partially basedon the informational data to at least one of a human, computer, orsystem. 79.-164. (canceled)